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Review
. 2023 Oct 23;16(20):2479-2497.
doi: 10.1016/j.jcin.2023.07.022.

Artificial Intelligence, Computational Simulations, and Extended Reality in Cardiovascular Interventions

Saurabhi Samant  1 , Jules Joel Bakhos  1 , Wei Wu  1 , Shijia Zhao  1 , Ghassan S Kassab  2 , Behram Khan  1 , Anastasios Panagopoulos  1 , Janaki Makadia  1 , Usama M Oguz  1 , Akshat Banga  1 , Muhammad Fayaz  1 , William Glass  3 , Claudio Chiastra  4 , Francesco Burzotta  5 , John F LaDisa Jr  6 , Paul Iaizzo  7 , Yoshinobu Murasato  8 , Gabriele Dubini  9 , Francesco Migliavacca  9 , Timothy Mickley  10 , Andrew Bicek  10 , Jason Fontana  11 , Nick E J West  12 , Peter Mortier  13 , Pamela J Boyers  3 , Jeffrey P Gold  3 , Daniel R Anderson  14 , James E Tcheng  15 , John R Windle  14 , Habib Samady  16 , Farouc A Jaffer  17 , Nihar R Desai  18 , Alexandra Lansky  18 , Carlos Mena-Hurtado  18 , Dawn Abbott  19 , Emmanouil S Brilakis  20 , Jens Flensted Lassen  21 , Yves Louvard  22 , Goran Stankovic  23 , Patrick W Serruys  24 , Eric Velazquez  18 , Pierre Elias  25 , Deepak L Bhatt  26 , George Dangas  26 , Yiannis S Chatzizisis  27
Affiliations
Free article
Review

Artificial Intelligence, Computational Simulations, and Extended Reality in Cardiovascular Interventions

Saurabhi Samant et al. JACC Cardiovasc Interv. .
Free article

Abstract

Artificial intelligence, computational simulations, and extended reality, among other 21st century computational technologies, are changing the health care system. To collectively highlight the most recent advances and benefits of artificial intelligence, computational simulations, and extended reality in cardiovascular therapies, we coined the abbreviation AISER. The review particularly focuses on the following applications of AISER: 1) preprocedural planning and clinical decision making; 2) virtual clinical trials, and cardiovascular device research, development, and regulatory approval; and 3) education and training of interventional health care professionals and medical technology innovators. We also discuss the obstacles and constraints associated with the application of AISER technologies, as well as the proposed solutions. Interventional health care professionals, computer scientists, biomedical engineers, experts in bioinformatics and visualization, the device industry, ethics committees, and regulatory agencies are expected to streamline the use of AISER technologies in cardiovascular interventions and medicine in general.

Keywords: artificial intelligence; cardiovascular intervention; extended reality; precision medicine; procedural planning; simulations; virtual clinical trials.

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Conflict of interest statement

Funding Support and Author Disclosures Supported by the National Institute of Health (R01 HL144690) and Dr Vincent Miscia Cardiovascular Research Fund. Dr Burzotta has received speaker honoraria from Medtronic, Abbott, and Abiomed. Dr Iaizzo is a consultant for Medtronic; and has received a research grant from Medtronic. Dr Bicek is an employee of Boston Scientific. Dr Fontana is an employee of Medtronic. Dr West is an employee and shareholder of Abbott. Dr Mortier is a cofounder of FEops. Dr Jaffer has received sponsored research from Canon, Siemens, Shockwave, Teleflex, and Mercator; is a consultant for Boston Scientific, Abbott Vascular, Siemens, Asahi Intecc, IMDS, Biotronik, Magenta Medical, and Philips; has equity interest in Intravascular Imaging Incorporated; and DurVena Inc Massachusetts General Hospital has a patent licensing arrangement with Canon, Terumo, and Spectrawave, and Dr Jaffer has the right to receive royalties. Dr Mena-Hurtado is a consultant for Abbott, COOK, Cardinal Health, Medtronic, and Optum Labs. Dr Abbott has received research funding from MicroPort and Boston Scientific; is on the advisory boards of Philips and Medtronic; and is a consultant for Abbott, and Recor. Dr Desai works under contract with the Centers for Medicare and Medicaid Services to develop and maintain performance measures used for public reporting and pay for performance programs. He reports research grants and consulting for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cytokinetics, Merck, Novartis, SCPharmaceuticals, and Vifor. Dr Brilakis has received consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Asahi Intecc, Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (board of directors), ControlRad, CSI, Elsevier, GE Healthcare, IMDS, InfraRedx, Medicure, Medtronic, Opsens, Siemens, and Teleflex; has received research support from Boston Scientific and GE Healthcare; is an owner of Hippocrates LLC; and is a shareholder of MHI Ventures, Cleerly Health, and Stallion Medical. Dr Bhatt is on the advisory boards of Boehringer Ingelheim, Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, Janssen, Level Ex, Medscape Cardiology, MyoKardia, NirvaMed, Novo Nordisk, PhaseBio, PLx Pharma, Regado Biosciences, and Stasys; is on the Board of Directors of Bristol Myers Squibb, Boston VA Research Institute, Society of Cardiovascular Patient Care, and TobeSoft; is the inaugural chair of the American Heart Association Quality Oversight Committee; is on data monitoring committees for Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Boston Scientific (Chair, PEITHO trial), Cleveland Clinic (including for the ExCEED trial, funded by Edwards Lifesciences), Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo), Novartis, and Population Health Research Institute; has received honoraria from American College of Cardiology (senior associate editor, Clinical Trials and News, ACC.org; Chair, ACC Accreditation Oversight Committee), Arnold and Porter law firm (work related to Sanofi/Bristol Myers Squibb clopidogrel litigation), 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), Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees), Cowen and Company, 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 and associate editor), K2P (cochair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (CME steering committees), MJH Life Sciences, Piper Sandler, Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national coleader, 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), and VA CART Research and Publications Committee (chair); has received research funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardax, CellProthera, Cereno Scientific, Chiesi, CSL Behring, Eisai, Ethicon, Faraday Pharmaceuticals, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Garmin, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Javelin, Lexicon, Lilly, Medtronic, MyoKardia, NirvaMed, Novartis, Novo Nordisk, Owkin, Pfizer, PhaseBio, PLx Pharma, Regeneron, Reid Hoffman Foundation, Roche, Sanofi, Stasys, Synaptic, The Medicines Company, and 89Bio; has received royalties from Elsevier (editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); is a site coinvestigator for Abbott, Biotronik, Boston Scientific, CSI, St. Jude Medical (now Abbott), Philips, and Svelte; is a trustee for American College of Cardiology; and has performed unfunded research for FlowCo, Merck, and Takeda. Dr Chatzizisis has received speaker honoraria, advisory board fees, and research grants from Boston Scientific; advisory board fees and research grants from Medtronic Inc.; issued U.S. patent (No. 11,026,749) and international patent pending (application No. PCT/US2020/057304) for the invention entitled “Computational simulation platform for the planning of interventional procedures”; Co-founder of ComKardia Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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