Virtual screens could make augmented reality more useful during cardiac ablation

Michael Walter | September 22, 2025 | Cardiovascular Business | Heart Rhythm

Sentiar CommandEP mixed reality system virtual screens augmented reality.

Panel A shows a large left atrial geometry with the menu ring fully expanded to the upper left corner of the map. To the right of the map is the force sensing screen with the force (in gms) and vector. Beneath the map, there is the ablation graph, with temperature (red), power (yellow) and impedance (green). The real time electrograms were placed beneath the ablation graph screen. Numeric ablation data is also present but layered behind the electrograms in the lower right-hand corner. Panel B shows a right atrial geometry with an expanded menu to the right of the map, and real time electrograms above the map. The numeric ablation parameter data was layered behind the map and above the electrograms. In panel C, there is a left atrial map with a fluoroscopic image to the right of the map, real time electrograms below the fluoroscopic image, below that are numeric ablation parameters layered beneath the electrograms and graphed ablation parameters below the map. Images and caption courtesy of Maher et al.

The use of augmented reality (AR) during cardiac ablation procedures may be improved by adding “virtual screens” that clinicians can customize as they see fit. That was the primary takeaway of a new analysis published in the Journal of Interventional Cardiac Electrophysiology.[1]

The study’s authors reviewed the potential of a new feature being developed for the CommandEP mixed reality system from St. Louis-based Sentiar. CommandEP provides real-time 3D digital images that appear via AR. This new feature adds up to five virtual screens to give the user’s AR environment a significant upgrade. It is still under development; this analysis examines the first use of the feature on animal models.

“During standard electrophysiology studies, physicians use multiple screens during the procedure, including electrograms (EGMs) (often live EGMs and review EGMs), intracardiac echocardiography, 3D electroanatomic mapping, mapping and fluoroscopy,” wrote first author Timothy R. Maher, MD, an electrophysiologist with Beth Israel Deaconess Medical Center, and colleagues. “In this new system, the data from these unique and discrete data sources are hard wired to an access point that wirelessly transmits the screen data to the head-mounted display. The virtual screen module allows users to create an individualized custom spatial layout of the chosen screens into virtual field of view.”

Maher et al. reviewed feedback from ablation procedures performed with this new technology on animal models.

“Post-testing survey questionnaires demonstrated high usability,” the authors wrote. “All users felt that the virtual screen module provided useful data during electrophysiology studies and liked the ability to arrange the screens as they wished. Additionally, there were no concerns about image quality from users who tested various inputs.”

Users also emphasized that gaining access to this technology “would be impactful to their practice.”

Two of this small study’s co-authors are Sentiar representatives. However, the group declared that their research was conducted outside of any “commercial or financial relationships that could be construed as a potential conflict of interest.”

Additional research will still be necessary to study how this technology may impact procedure lengths and patient outcomes. Similar features are being developed by other medtech companies, the group added.

Click here for the full analysis.