Holographic Display Developed for cardiac ablation procedure

A wife (surgeon) and husband (engineer) team have developed a holographic display to use during a cardiac ablation procedure.

The team of engineers and physicians from Washington University in St. Louis have displayed for the first time that using a holographic display improves physician accuracy when performing a procedure to treat an irregular heartbeat.

Jennifer N. Avari Silva, MD, associate professor of pediatrics at the School of Medicine, and Jonathan Silva, associate professor of biomedical engineering in the McKelvey School of Engineering, were in charge of a team that tested the Microsoft HoloLens headset with custom software during cardiac ablation procedures on patients at St. Louis Children’s Hospital.

Wife and husband dream team

The wife and husband. Jennifer N.Afari, MD, associate professor of pediatrics at the School of Medicine, and Jonathan Silva, associate professor of biomedical engineering in the Mckelvey School of Engineering, were in charge of a team that tested the headset built with state of the art software at St.Louis Children’s Hospital.

Results of the trial were published in the Journal of the American College of Cardiology – Clinical Electrophysiology July 2020, International Conference on Human-Computer Interaction July 10, 2020, and IEEE Journal of Translational Engineering in Health and Medicine, July 3, 2020.

In an ablation procedure using existing technology, known as an electroanatomic mapping system (EAMS), a technician controls the catheters while the physician views the images on monitors presented in two different planes.

Holographic Display helps with cardiac ablation procedure

Jennifer Silva, also director of pediatric electrophysiology at St. Louis Children’s Hospital, said that standard-of-care technology is antiquated, and the team believed it could do better.

Jon Silva and his team of engineers created software for the Microsoft HoloLens headset that converts the data from the catheters fed into the patient’s heart into an image that hovers over the patient.

The headset, which weighs roughly a pound, allows the physician to take control of the procedure by guiding the controls whilst keeping the hands clean and sterile.

ELVIS

The system known as the Enhanced Electrophysiology Visualization and Interaction System (?LVIS) provides a 3D digital image of the patient’s electroanatomic maps that provide a picture of the inside of the heart, which they can measure and manipulate during the procedure.

Jon Silva said that the technology has caught up with the application.

“The old headsets were slow to update and made the users sick,” he said. “The development of mobile phones and mobile technology and computer has enabled these kinds of displays and headsets.”

To test the device, two physicians at St. Louis Children’s Hospital received a short training session on the device before using it on a total of 16 pediatric patients.

During a post-procedure waiting phase, the physicians were given 60 seconds to navigate to each of the five target markers within the geometry of the heart, using both the 3D ?LVIS and the 2D EAMS technology.

The results were in favour of the 3d ELVIS, with physicians being significantly more accurate.

“Without the use of the ?LVIS 3D display, a significant fraction of ablation lesions, 34%, would be made outside of the target area, as opposed to 6% with ?LVIS 3D display,” Jon Silva said. “We expect that this will improve patient outcomes and potentially reduce the need for repeat procedures.”

Becoming market-ready

Jennifer Silva said the team are learning by the day as the software becomes market-ready.

“What ended up being equally important, if not more important, was that this was the springboard for everything that is to come, not only that we can visualize it better, but that we can control it,” Jennifer Silva said. “There are people working in this extended reality space who have come to conclusions that the control is the strongest value-add, particularly in medical applications.”

The Silva’s licensed their technology to SentiAR, which is further developing the augmented reality software. SentiAR has funding from the National Institutes of Health as well as St. Louis investment firms Cultivation Capital and BioGenerator.

They are working with the university’s Office of Technology Management to bring the technology to market and have submitted it to the U.S. Food & Drug Administration for approval.

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