{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:55:29Z","timestamp":1792608929663,"version":"4.5.0"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The CommandEP system v2 (Sentiar, St. Louis, MO) utilizes an augmented reality headset (Magic Leap, Plantation, FL) to display a real-time 3-dimensional electroanatomic map, catheter locations, and ablation catheter contact force data to the electrophysiologist using a hands-free interface. In the intra-PARADIGM study (Procedural Augmented Reality Assessment in a 3-Dimensional Image Guided Modality), the impact of the CommandEP system on the electrophysiologist\u2019s ability to navigate accurately, intraprocedural communications, and system usability were studied.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>CommandEP was used prospectively in patients undergoing electrophysiologist studies at 2 sites with 8 users. The electrophysiologist\u2019s ability to navigate accurately was calculated as catheter tip displacement from the target using CommandEP versus the electroanatomic mapping system. Physician-mapper interactions were quantified and classified as high- versus low-quality communications (high quality directly impacted navigation, medical decision-making, or patient care). Usability was assessed via survey.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 102 patients completed the study with the following diagnoses: atrial fibrillation (n=78\/102, 76%), atrial flutter (8\/102, 8%), atrial tachycardia\/supraventricular tachycardia (n=9\/102, 9%), premature ventricular contraction (n=6\/102, 6%), and cardiac neuroablation (1\/102, 1%). The physician\u2019s ability to navigate was more accurate when using the CommandEP system with an average distance of 2.98\u00b12 mm versus electroanatomic mapping system 3.27\u00b12 mm (\n              <jats:italic>P<\/jats:italic>\n              =0.02); 21% of points navigated using CommandEP versus 28% of points navigated using electroanatomic mapping system were &gt;4 mm from the target (\n              <jats:italic>P<\/jats:italic>\n              =0.03). In all, 393 communications during study tasks were counted with 30 events when using CommandEP versus 363 events when using electroanatomic mapping system. Subanalysis showed no difference in accuracy pre- versus postcontact force (p=ns) and a slight reduction in both low- and high-quality communications (p=ns). Notably, 94% agreed\/strongly agreed that they felt comfortable using the system, and 72% agreed\/strongly agreed they would be comfortable using the CommandEP system in most\/all EPS.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The CommandEP system improved physicians\u2019 ability to navigate accuracy, reduced the number of communications, increased the quality of communications, and had high usability.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.124.013222","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T09:05:24Z","timestamp":1743671124000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["The PARADIGM Study: Procedural Augmented Reality Assessment in a 3-Dimensional Image-Guided Modality"],"prefix":"10.1161","volume":"18","author":[{"given":"Alan","family":"Hanley","sequence":"first","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Boston (A.H., J.S., W.J.H., G.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2766-4726","authenticated-orcid":true,"given":"Andrew","family":"Locke","sequence":"additional","affiliation":[{"name":"Beth Israel Hospital, Boston, MA (A.L., P.T., R.D., A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-529X","authenticated-orcid":true,"given":"Jagmeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Boston (A.H., J.S., W.J.H., G.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7076-5327","authenticated-orcid":true,"given":"Patricia","family":"Tung","sequence":"additional","affiliation":[{"name":"Beth Israel Hospital, Boston, MA (A.L., P.T., R.D., A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4703-0579","authenticated-orcid":true,"given":"William J.","family":"Hucker","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Boston (A.H., J.S., W.J.H., G.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"D\u2019Angelo","sequence":"additional","affiliation":[{"name":"Beth Israel Hospital, Boston, MA (A.L., P.T., R.D., A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5295-1893","authenticated-orcid":true,"given":"Jennifer N.","family":"Avari Silva","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Washington University in St. Louis School of Medicine, MO (J.N.A.S.)."},{"name":"Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, MO (J.N.A.S., J.R.S.)."},{"name":"Sentiar, Inc, St. Louis, MO (J.N.A.S., J.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3696-3955","authenticated-orcid":true,"given":"Jonathan R.","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, McKelvey School of Engineering, Washington University in St. Louis, MO (J.N.A.S., J.R.S.)."},{"name":"Sentiar, Inc, St. Louis, MO (J.N.A.S., J.R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8769-1411","authenticated-orcid":true,"given":"Andre","family":"d\u2019Avila","sequence":"additional","affiliation":[{"name":"Beth Israel Hospital, Boston, MA (A.L., P.T., R.D., A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8425-4455","authenticated-orcid":true,"given":"Gregory F.","family":"Michaud","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Boston (A.H., J.S., W.J.H., G.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.04.036"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.13.5.330"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2010.07.051"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.12686"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10648-015-9352-0"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.caeo.2021.100036"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.124.013222","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T18:00:40Z","timestamp":1744740040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.124.013222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1161\/CIRCEP.124.013222"],"URL":"https:\/\/doi.org\/10.1161\/circep.124.013222","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}