Advanced XR-Based 6-DOF Catheter Tracking System for Immersive Cardiac Intervention Training

Abstract: Extended Reality (XR) technologies are gaining traction as effective tools for medical training and procedural guidance, particularly in complex cardiac interventions. This paper presents a novel system for real-time 3D tracking and visualization of intracardiac echocardiography (ICE) catheters, with precise measurement of the roll angle. A custom 3D-printed setup, featuring orthogonal cameras, captures biplane video of the catheter, while a specialized computer vision algorithm reconstructs its 3D trajectory, localizing the tip with sub-millimeter accuracy and tracking the roll angle in real-time. The system's data is integrated into an interactive Unity-based environment, rendered through the Meta Quest 3 XR headset, combining a dynamically tracked catheter with a patient-specific 3D heart model. This immersive environment allows the testing of the importance of 3D depth perception, in comparison to 2D projections, as a form of visualization in XR. Our experimental study, conducted using the ICE catheter with six participants, suggests that 3D visualization is not necessarily beneficial over 2D views offered by the XR system; although all cardiologists saw its utility for pre-operative training, planning, and intra-operative guidance. The proposed system qualitatively shows great promise in transforming catheter-based interventions, particularly ICE procedures, by improving visualization, interactivity, and skill development.