Virtual and Augmented Reality in Cardiovascular Care: State-of-the-Art and Future Perspectives

Affiliations

¹ Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany. Electronic address: christian.jung@med.uni-duesseldorf.de.
² Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany.
³ Department of Anesthesiology and Intensive Care, Paracelsus Medical University of Salzburg, Salzburg, Austria; Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
⁴ Department of Internal Medicine I, Medical Faculty, Friedrich Schiller University Jena, University Hospital Jena, Jena, Germany.
⁵ Pediatric Cardiology Division, Department of Pediatrics, Washington University in Saint Louis, School of Medicine, Saint Louis, Missouri, USA; Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in Saint Louis, Saint Louis, Missouri, USA; SentiAR, Saint Louis, Missouri, USA.
⁶ Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in Saint Louis, Saint Louis, Missouri, USA; SentiAR, Saint Louis, Missouri, USA.
⁷ Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: https://twitter.com/DLBHATTMD.
⁸ Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany; Cardiovascular Research Institute Duesseldorf, Düsseldorf, Germany.

PMID: 34656478
DOI: 10.1016/j.jcmg.2021.08.017

Free article

Review

Virtual and Augmented Reality in Cardiovascular Care: State-of-the-Art and Future Perspectives

Christian Jung et al. JACC Cardiovasc Imaging. 2022 Mar.

Free article

. 2022 Mar;15(3):519-532.

doi: 10.1016/j.jcmg.2021.08.017. Epub 2021 Oct 13.

Authors

Affiliations

¹ Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany. Electronic address: christian.jung@med.uni-duesseldorf.de.
² Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany.
³ Department of Anesthesiology and Intensive Care, Paracelsus Medical University of Salzburg, Salzburg, Austria; Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
⁴ Department of Internal Medicine I, Medical Faculty, Friedrich Schiller University Jena, University Hospital Jena, Jena, Germany.
⁵ Pediatric Cardiology Division, Department of Pediatrics, Washington University in Saint Louis, School of Medicine, Saint Louis, Missouri, USA; Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in Saint Louis, Saint Louis, Missouri, USA; SentiAR, Saint Louis, Missouri, USA.
⁶ Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in Saint Louis, Saint Louis, Missouri, USA; SentiAR, Saint Louis, Missouri, USA.
⁷ Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: https://twitter.com/DLBHATTMD.
⁸ Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, University Hospital Düsseldorf, Düsseldorf, Germany; Cardiovascular Research Institute Duesseldorf, Düsseldorf, Germany.

PMID: 34656478
DOI: 10.1016/j.jcmg.2021.08.017

Abstract

Applications of virtual reality (VR) and augmented reality (AR) assist both health care providers and patients in cardiovascular education, complementing traditional learning methods. Interventionalists have successfully used VR to plan difficult procedures and AR to facilitate complex interventions. VR/AR has already been used to treat patients, during interventions in rehabilitation programs and in immobilized intensive care patients. There are numerous additional potential applications in the catheterization laboratory. By using AR, interventionalists could combine visual fluoroscopy information projected and registered on the patient body with data derived from preprocedural imaging and live fusion of different imaging modalities such as fluoroscopy with echocardiography. Persistent technical challenges to overcome include the integration of different imaging modalities into VR/AR and the harmonization of data flow and interfaces. Cybersickness might exclude some patients and users from the potential benefits of VR/AR. Critical ethical considerations arise in the application of VR/AR in vulnerable patients. In addition, digital applications must not distract physicians from the patient. It is our duty as physicians to participate in the development of these innovations to ensure a virtual health reality benefit for our patients in a real-world setting. The purpose of this review is to summarize the current and future role of VR and AR in different fields within cardiology, its challenges, and perspectives.

Keywords: augmented reality; cardiovascular care; imaging; virtual reality.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Bhatt has been a member of the Advisory Boards for Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, Level Ex, Medscape Cardiology, PhaseBio, PLx Pharma, Regado Biosciences; a member of the Board of Directors for Boston VA Research Institute, Society of Cardiovascular Patient Care, TobeSoft; the Chair of American Heart Association Quality Oversight Committee; a member of Data Monitoring Committees for the Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic (including for the ExCEED trial, funded by Edwards), Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo), Population Health Research Institute; has received honoraria from the American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Vice-Chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), K2P (Co-Chair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (CME steering committees), MJH Life Sciences, Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer), Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees), Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); Research Funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Cardax, Chiesi, CSL Behring, Eisai, Ethicon, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Idorsia, Ironwood, Ischemix, Lexicon, Lilly, Medtronic, Pfizer, PhaseBio, PLx Pharma, Regeneron, Roche, Sanofi Aventis, Synaptic, The Medicines Company; Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); has been a Site Co-Investigator for Biotronik, Boston Scientific, CSI, St. Jude Medical (now Abbott), Svelte; a Trustee for the American College of Cardiology; and has received unfunded research from FlowCo, Merck, Novo Nordisk, Takeda. Dr Jung has received speaking fees for Bristol-Meyer-Squibb, Edwards Lifesciences, Daichi Sankyo, and Weltenmacher; and has received consulting fees for Janssen Research. Institutional research support has been received by Medicure Pharma and Edwards Lifesciences. Dr J Jennifer N. Avari Silva is co-inventor, co-founder, Chief Medical Officer at SentiAR; further disclosures: Consultant, Abbott; DSBM/CECC, Cardialen; Research Support, Abbott, AliveCor. Dr Jonathan R. Silva is co-inventor, co-founder, Chief Technology Officer, Board of Directors at SentiAR. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Virtual and Augmented Reality in Cardiovascular Care: State-of-the-Art and Future Perspectives

Affiliations

Virtual and Augmented Reality in Cardiovascular Care: State-of-the-Art and Future Perspectives

Authors

Affiliations

Abstract

Conflict of interest statement

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Research Materials