Visual Behaviour Strategies of Operators during Catheter-Based Cardiovascular Interventions

The aim was to gain insights into the visual behaviour and the perceptual skills of operators during catheter-based cardiovascular interventions (CBCVIs). A total of 33 CBCVIs were performed at the University Hospital Zurich by five operators, two experts and three novices, while wearing eye tracking glasses. The visual attention distribution on three areas of interest (AOIs) the "Echo screen", "Fluoro screen" and "Patient" was analysed for the transseptal puncture procedure. Clear visual behaviour patterns were observable in all cases. There is a significant differences in visual attention distribution of the experts compared to the novices. Experts spent 79% of dwell time on the Echo screen and 17% on the Fluoro screen, novices spent 52% on the Echo screen and 40% on the Fluoro screen. Additionally, results showed that experts focused their gaze on smaller areas than novices during critical interventional actions. Operators seem to exhibit identifiable visual behaviour patterns for CBCVIs. These identifiable patterns were significantly different between the expert and the novice operators. This indicates that the visual behaviour of operators could be employed to assist transfer of experts' perceptual skills to novices and to develop tools for objective performance assessment.