MIXED REALITY TECHNOLOGY REDUCES OPERATOR STRESS DURING TRANSCATHETER EDGE-TO-EDGE REPAIR: RESULTS FROM THE MIMIC-TEER PILOT STUDY
Topic: Interventional cardiology | |
| Type: Poster - technik , Number in the programme: 117 | |
| Přeček D. 1, Hecko J. 1, Januška J. 2, Hudec M. 2, Jiravský O. 3 1 Telemedicínské centrum, Nemocnice AGEL Třinec-Podlesí a.s., Třinec, 2 Intervenční kardiologie, Nemocnice AGEL Třinec-Podlesí a.s., Třinec, 3 Elektrofyziologie, Nemocnice AGEL Třinec-Podlesí a.s., Třinec | |
Transcatheter edge-to-edge repair (TEER) requires complex spatial interpretation of fluoroscopic and echocardiographic data, imposing substantial cognitive and physiological stress on operators. Mixed reality (MR) technology may reduce this burden by enabling intuitive three-dimensional visualization, but objective in-procedure stress data are lacking. To evaluate the impact of MR technology using Microsoft HoloLens 2 on operator physiological stress, perceived workload, and procedural efficiency during TEER. In this prospective single-center pilot study, 20 consecutive TEER procedures were alternately allocated to MR-assisted (n=10) or standard workflow (n=10). All procedures were performed as first cases of the day by two experienced interventional cardiologists. Operator stress was assessed using heart rate variability (HRV), salivary cortisol, corrected QT interval, NASA Task Load Index (NASA-TLX), State-Trait Anxiety Inventory (STAI), and Simulator Sickness Questionnaire (SSQ). Procedural time and radiation exposure were secondary endpoints. MR-assisted procedures demonstrated significantly higher HRV compared with standard workflow (median [IQR]: 39.0 [27.5–45.0] vs 25.5 [21.0–28.0]; p=0.013; large effect size), indicating reduced physiological stress. Subjective workload was numerically lower in the MR group, with medium-to-large effect sizes for mental and physical demand. Procedural duration and radiation exposure were comparable between groups. Sensitivity analysis excluding extreme-complexity cases confirmed persistence of the HRV benefit.Conclusions Mixed reality technology significantly reduces operator physiological stress during TEER without compromising procedural efficiency or radiation exposure. These findings support MR as a promising adjunct for complex structural heart interventions and justify larger randomized trials. | |
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