Effects of a Mixed-Reality Headset on Procedural Outcomes in the Cardiac Catheterization Laboratory

Background: Mixed reality head-mounted displays (MR-HMD) are a novel and emerging tool in healthcare. There is a paucity of data on the safety and efficacy of the use of MR-HMD in the cardiac catheterization laboratory (CCL). We sought to analyze and compare fluoroscopy time, procedure time, and complication rates with right heart catheterizations (RHCs) and coronary angiographies (CAs) performed with MR-HMD versus standard LCD medical displays. Methods: This is a non-randomized trial that included patients who underwent RHC and CA with MR-HMD between August 2019 and January 2020. Their outcomes were compared to a control group during the same time period. The primary endpoints were procedure time, fluoroscopy time, and dose area product (DAP). The secondary endpoints were contrast volume and intra and postprocedural complications rate. Results: 50 patients were enrolled in the trial, 33 had a RHC done, and 29 had a diagnostic CA performed. They were compared to 232 patients in the control group. The use of MR-HMD was associated with a significantly lower procedure time (20 min (IQR 14–30) vs. 25 min (IQR 18–36), p = 0.038). There were no significant differences in median fluoroscopy time (1.5 min (IQR 0.7–4.9) in the study group vs. 1.3 min (IQR 0.8–3.1), p = 0.84) or median DAP (165.4 mGy·cm² (IQR 13–15,583) in the study group vs. 913 mGy·cm² (IQR 24–6291), p = 0.17). There was no significant increase in intra- or post-procedure complications. Conclusion: MR-HMD use is safe and feasible and may decrease procedure time in the CCL.