Ayman Aslam- [email protected]
The significance of cardiology is crucial in preventing a wide range of heart diseases. In
cardiology, uses of technology and recent advancements in medical techniques have proven to
be efficient in assisting doctors in diagnosis and prognosis results. In this article, we will
investigate how technology is now being used in cardiovascular treatments, recent innovations in
the cardiology field the challenges and disparities this could cause and what the future of medical
practices in this field could look like if we continue to utilize these options.
UTILIZATION OF ARTIFICIAL INTELLIGENCE (AI) AND MACHINE
LEARNING (ML)
Firstly, a notable example of these options is AI. First proposed in the 1950s, AI is a large field
that has become popularized due to its recent growth and many applications. However, in
cardiology, AI is now more useful than ever in diagnostics and research. Currently, AI
algorithms are being used to diagnose CVDs such as arrhythmia, specifically atrial fibrillation,
by detecting patterns in heartbeat and matching those to a patient’s symptoms [Harmon et al.,
2023], or hypertrophic cardiomyopathy (HCM), where AI has made it possible to sift through
large data sets from a patient’s genomes allowing researchers to relate physical and genetic data
in HCM [Farrwh, 2023]. This allows cardiologists to make decisions for patient healthcare based
on the data provided and it has often been proven that the best way to make decisions from data
is to utilize methods taken from machine learning (ML) [Sarker, 2018]. Furthermore, AI can also
be used in image analysis, cardiovascular imagery uses AI to interpret imaging as it can
determine an outcome based on the amount of substance in the coronary artery, further
supporting physicians in planning and diagnosis based on the quantities provided [Reddy, et al.,
2024]. AI not only supports doctors but also patients, Wearable devices, and cardiac implantable
electronic devices (CIED) use ML to detect changes in heartbeat and therefore predict
cardiovascular diseases such as heart failure and arrhythmia [Krittanawong et al., 2021]
INNOVATIONS IN CARDIOLOGY
Recent innovations in cardiology involve mostly technological advancements. 3D printing, for
one, was popularized in the early 2000s in medicine [Ventola, 2014] due to its use to develop a
model of a patient’s heart for better pre-surgical planning, education, and surgical practice. In
addition, hybrid imaging techniques e.g., PET-CT and PET-MRI are now being used for a more
precise diagnosis and treatment planning [Saraste, 2012]. Less invasive techniques have grown
in popularity over the past 10 years and have been developed to reduce the risk of infection and
decrease pain and recovery time, especially in cardiothoracic surgeries. Transcatheter Aortic
Valve Replacement (TAVR) was developed in the 1980s by a Danish researcher known as H.R.
Anderson who performed this concept on pigs, and in 2002, Dr Alain Cribier performed the first
successful TAVR on a human [Mahmaljy, Tawney and Young, 2023]. Minimally invasive
cardiac surgery (MICS), another less invasive technique, utilizes small incisions to minimize
tissue damage and recovery time [Mohiuddin, 2023]. Coronary artery bypass grafting (CABG),
first introduced in the 1960s and first performed by Robert Goetz [Konstantinov, 2000], is a
MICS that is used to prevent coronary artery disease; it avoids the need to split the sternum by
having a small incision on the left side of the chest between the ribs. In 1998, however, the first
completely endoscopic robotically assisted CABG was performed [Chitwood, 2022] and since
then, the use of robots to improve precision and dexterity in cardiac surgery has only increased,
for example, the most common robotic-assisted procedure today, mitral valve replacement,
where robots are commonly used to assist in repairing or replacing mitral valves using smaller
incisions [Bush, 2013] . Atrial Septal Defect (ASD) which involves repairing cavities in the heart
with robotic assistance [Yun, 2022].
CHALLENGES REGARDING ADVANCEMENTS
Whilst these strides in innovation are massively impressive, it is also important to note that
where there are opportunities also lie challenges, and the advancement of cardiology is no
exception to this. For starters, internationally, disparities in access to cardiological treatments
and surgeries lead to patients in LIC regions not being able to benefit from the latest treatments
and patients even receiving sub optimal treatments [Agati, 2023], in contrast to affluent areas
where these advancements are standard, an example of this is technological gaps; hybrid
imaging techniques are incredibly scarce in limited-resource setting and in some cases aren’t
possible to access [Kashyap, 2013]. Also, Procedural limitations towards MICS surgeries such as
TAVR are inaccessible in poverty communities, reducing treatment options available to patients
with severe conditions. However, efforts to reduce these disparities have been effective in
countering them; an elevated level of political commitment [Vervoort, 2020] has resulted in
programs such as the “Global Hearts Initiative,” launched in 2016 and ran by the World Health
Organisation (WHO) by the which aims to deliver cardiovascular care to everyone across the
globe. Another being the “Global Heart Hub”, a non-profit organisation which aims to amplify
the voices of those affected by heart disease. The implementation of these services allows for
innovative treatments to be more accessible amongst low-income countries, eliminating
disparities in wealth, however, more work will need to be done to completely irradicate the
condition which these countries find themselves in.
THE FUTURE OF CARDIOLOGY
As we look ahead, the future of cardiology promises to shape the future of how we view
healthcare; the contribution that inventions such as AI and ML can have could significantly
impact the efficiency in which diseases and issues are spotted [Kumar 2022], whilst the impact
of AI is still limited, it is possible that could change quickly given the recent surge of AI being
used, it is something that should definitely be embraced moving forward as its impact could be
drastic. advanced modelling of organs like the heart could lead to an increase in the discovery of
MICS and more minimally invasive techniques and the use of robots in assisting this could lead
to other systems such as AI being integrated into these systems, allowing them to perform more
complex tasks never thought possible. If 3D printing continues to be used, then we could see the
rise of implantable organs using this technology [Aimar, 2019]. The political attention that is
being drawn towards cardiovascular care could lead to more advanced technologies and surgeries
being accessible around the world, we could also see a rise in more innovative techniques being
developed if more physicians be allocated to these regions.
CONCLUSION
In conclusion, the rapid evolution of advancements in cardiology has and will continue to have
revolutionary effects in medicine. Ultimately, Innovations are something that we should
encourage and embrace. However, it comes with drawbacks, it is important that we recognise
and shed light on these issues moving forwards, as in doing so, these advancements could
become standard.
REFERENCES
Aimar, A., Palermo, A. and Innocenti, B., 2019. The role of 3D printing in medical applications:
a state of the art. Journal of healthcare engineering, 2019(1), p.5340616.
Al Farrwh M. 2023 ‘AI in personalized medicine: Study Unveils Novel Classification of
Hypertrophic Cardiomyopathy.’ MRC Laboratory of Medical Sciences.
Bush, B., Nifong, L.W., Alwair, H. and Chitwood Jr, W.R., 2013. Robotic mitral valve
surgery—current status and future directions. Annals of cardiothoracic surgery, 2(6), p.814.
Chitwood Jr, W.R., 2022. Historical evolution of robot-assisted cardiac surgery: a 25-year
journey. Annals of Cardiothoracic Surgery, 11(6), p.564.
Harky, A. and Hussain, S.M.A., 2019. Robotic cardiac surgery: the future gold standard or an
unnecessary extravagance?. Brazilian Journal of Cardiovascular Surgery, 34(4), pp.XII-XIII.
Harmon, D.M., Sehrawat, O., Maanja, M., Wight, J. and Noseworthy, P.A., 2023. Artificial
intelligence for the detection and treatment of atrial fibrillation. Arrhythmia & Electrophysiology
Review, 12.
Kashyap, R., Dondi, M., Paez, D. and Mariani, G., 2013, May. Hybrid imaging worldwide—
challenges and opportunities for the developing world: a report of a technical meeting organized
by IAEA. In Seminars in Nuclear Medicine (Vol. 43, No. 3, pp. 208-223). WB Saunders.
Konstantinov, I.E., 2000. Robert H. Goetz: the surgeon who performed the first successful
clinical coronary artery bypass operation. The annals of thoracic surgery, 69(6), pp.1966-1972.
Krittanawong, C., Rogers, A.J., Johnson, K.W., Wang, Z., Turakhia, M.P., Halperin, J.L. and
Narayan, S.M., 2021. Integration of novel monitoring devices with machine learning technology
for scalable cardiovascular management. Nature Reviews Cardiology, 18(2), pp.75-91.
Kumar, Y., Koul, A., Singla, R. and Ijaz, M.F., 2023. Artificial intelligence in disease diagnosis:
a systematic literature review, synthesizing framework and future research agenda. Journal of
ambient intelligence and humanized computing, 14(7), pp.8459-8486.
Mahmaljy, H., Tawney, A. and Young, M., 2017. Transcatheter aortic valve replacement.
Mohiuddin, K. and Swanson, S.J., 2013. Maximizing the benefit of minimally invasive surgery.
Journal of surgical oncology, 108(5), pp.315-319.
Reddy, D.T., Grewal, I., Pinzon, L.F.G., Latchireddy, B., Goraya, S., Alansari, B.A. and Gadwal,
A., 2024. The Role of Artificial Intelligence in Healthcare: Enhancing Coronary Computed
Tomography Angiography for Coronary Artery Disease Management. Cureus, 16(6).
Saraste, A. and Knuuti, J., 2012. Cardiac PET, CT, and MR: what are the advantages of hybrid
imaging?. Current cardiology reports, 14, pp.24-31.
Ventola, C.L., 2014. Medical applications for 3D printing: current and projected uses. Pharmacy
and Therapeutics, 39(10), p.704.
Vervoort D, Parikh UM, Raj A, Swain JD. Global cardiovascular care: an overview of high-level
political commitment. Asian Cardiovascular and Thoracic Annals. 2020;28(5):258-265.
doi:10.1177/0218492320930844
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