Purpose The data which is available to surgeons before, during and after surgery is steadily increasing in quantity as well as diversity. When planning a patient’s treatment, this large amount of information can be difficult to interpret. To aid in processing the information, new methods need to be found to present multimodal patient data, ideally combining textual, imagery, temporal and 3D data in a holistic and context-aware system.
Using our framework, @cite_14 have created an interactive VR ablation simulation which allows physicians to explore the effects which ablation lesions have on atrial arrhythmias. Their work focuses on the usage of the framework for one specific application. In contrast, this article describes the underlying framework itself, its system components and design as well as a more general evaluation.
@cite_14
2794852957
Atrial arrhythmias like atrial fibrillation and atrial flutter are a major health challenge in developed countries. Radiofrequency ablation performed via intracardiac catheters is a curative therapy for these reentrant arrhythmias. However, the optimal location of ablation lesions is not straightforward to determine, particularly for complex activation patterns. Thus, a clinical need for tools to intuitively visualize complex activation patterns and to provide a platform to evaluate different ablation strategies in dry runs is apparent. Here, we present a virtual reality system that allows to interactively simulate atrial excitation propagation and place ablation lesions. Our software builds on the IMHOTEP framework for the Unity3D engine and implements a multithreaded model-view-controller design pattern. Excitation propagation is computed using a fast marching approach considering refractoriness. Interactive rewind and playback is supported through a combination of the flyweight pattern for simulation data with complete snapshots for key frames. The system was evaluated in a user study using the HTC Vive™ headset including two controllers. For high fidelity virtual reality interaction, a minimum frame rate of 60 per second is required. In a biatrial anatomical model comprising 36,059 nodes (Figure 1), even complex activation patterns with multiple wavefronts could be simulated and rendered down to 2× slow motion (1 sec activation sequence displayed during 2 sec wall time) on a desktop machine. Results of the user study suggest added value regarding the comprehension of arrhythmias and ablation options and very good intuitiveness of the user interface requiring almost no teach-in. The virtual reality tool is ready to be used for educational purposes and prepared to import personalized models supporting diagnosis and therapy planning for atrial arrhythmias in the future.