title: Interactive training system for interventional electrocardiology procedures.
abstract: Recent progress in cardiac catheterization and devices has allowed the development of new therapies for severe cardiac diseases like arrhythmias and heart failure. The skills required for such interventions are very challenging to learn, and are typically acquired over several years. Virtual reality simulators may reduce this burden by allowing trainees to practice such procedures without risk to patients. In this paper, we propose the first training system dedicated to cardiac electrophysiology, including pacing and ablation procedures. Our framework involves the simulation of a catheter navigation that reproduces issues intrinsic to intra-cardiac catheterization, and a graphics processing unit (GPU)-based electrophysiological model. A multithreading approach is proposed to compute both physical simulations (navigation and electrophysiology) asynchronously. With this method, we reach computational performances that account for user interactions in real-time. Based on a scenario of cardiac arrhythmia, we demonstrate the ability of the user-guided simulator to navigate inside vessels and cardiac cavities with a catheter and to reproduce an ablation procedure involving: extra-cellular potential measurements, endocardial surface reconstruction, electrophysiology mapping, radio-frequency (RF) ablation, as well as electrical stimulation. A clinical evaluation assessing the different aspects of the simulation is presented. This works is a step towards computerized medical learning curriculum.
authors.affiliation: Inria, France. Electronic address: contact@hugotalbot.com.
authors.forename: Hugo
authors.initials: H
authors.lastname: Talbot
authors.affiliation: Inria, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Spadoni
authors.affiliation: Inria, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Duriez
authors.affiliation: Inria, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Sermesant
authors.affiliation: Department of Cardiology, Guy's and St. Thomas' NHS, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: O'Neill
authors.affiliation: Hôpital Haut-l'évêque - IHU Liryc, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.affiliation: Inria, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cotin
authors.affiliation: Inria, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Delingette
mesh_terms: D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods; D017115:Catheter Ablation / Q000379:methods; D003196:Computer Graphics; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D008955:Models, Cardiovascular; D000066908:Simulation Training / Q000379:methods*; D014584:User-Computer Interface
keywords: Endovascular navigation; Interactive simulation; Real-time electrophysiology; Training simulator