Performance Evaluation of Mixed Reality Display for Guidance During Transcatheter Cardiac Mapping and Ablation.

Walter M Blume,Jonathan R Silva,Jennifer N Avari Silva,Aarti S Dalal,Michael K Southworth,George F Van Hare

doi:10.1109/jtehm.2020.3007031

Walter M Blume, Jonathan R Silva + Show 4 more

Open Access

https://doi.org/10.1109/jtehm.2020.3007031

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Abstract

Cardiac electrophysiology procedures present the physician with a wealth of 3D information, typically presented on fixed 2D monitors. New developments in wearable mixed reality displays offer the potential to simplify and enhance 3D visualization while providing hands-free, dynamic control of devices within the procedure room. Objective: This work aims to evaluate the performance and quality of a mixed reality system designed for intraprocedural use in cardiac electrophysiology. Method: The Enhanced Electrophysiology Visualization and Interaction System (ĒLVIS) mixed reality system performance criteria, including image quality, hardware performance, and usability were evaluated using existing display validation procedures adapted to the electrophysiology specific use case. Additional performance and user validation were performed through a 10 patient, in-human observational study, the Engineering ĒLVIS (E2) Study. Results: The ĒLVIS system achieved acceptable frame rate, latency, and battery runtime with acceptable dynamic range and depth distortion as well as minimal geometric distortion. Bench testing results corresponded with physician feedback in the observational study, and potential improvements in geometric understanding were noted. Conclusion: The ĒLVIS system, based on current commercially available mixed reality hardware, is capable of meeting the hardware performance, image quality, and usability requirements of the electroanatomic mapping display for intraprocedural, real-time use in electrophysiology procedures. Verifying off the shelf mixed reality hardware for specific clinical use can accelerate the adoption of this transformative technology and provide novel visualization, understanding, and control of clinically relevant data in real-time.

Highlights

Invasive surgical procedures have vastly improved patient outcomes by minimizing trauma, miniaturizing wounds, accelerating recovery and reducing hospital stays
The distortion measured was below AAPM-TG18 guidelines of less than 5% for secondary class displays, and less than 2% guidance given for primary displays
This the first report to describe a set of testing parameters to evaluate a mixed reality heads up display for medical use in a specific field, based on previously published medical imaging display parameters including human in the loop testing to evaluate near-eye 3D stereoscopic displays

Summary

Introduction

Invasive surgical procedures have vastly improved patient outcomes by minimizing trauma, miniaturizing wounds, accelerating recovery and reducing hospital stays. Sophisticated navigation systems have been developed to sense and display the position of the surgeon’s tools relative to the patient’s anatomy [1]–[5] and have gained wide adoption. Despite these technical advances, interventional physicians who are performing minimally invasive procedures experience significantly greater mental fatigue in comparison to those who perform open procedures [6]–[8]. The mental burden of processing these additional data and reconstructing the 3-dimensional (3D) features of the patient anatomy from orthogonal 2-dimensional (2D) displays is a significant contributor to this fatigue.

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