Use of smart glasses for remote technical support in cardiac device implantation: efficiency, safety, and environmental impact

Abstract Background Smart glasses are emerging as an innovative tool in clinical practice, enabling remote technical support during complex cardiac device implantations. This technology allows procedural guidance without requiring an on-site technician, potentially improving efficiency and expanding access to expert support. This study evaluates the feasibility, advantages, and potential environmental benefits of using smart glasses for remote support in cardiac device implantation procedures. Methods At a tertiary center, all consecutive procedures for implantation or replacement of cardiac devices (PM, ICD, CRT-D, and leadless pacemakers) were performed with remote support from a Medtronic technician via smart glasses. During the procedures, the technician accessed real-time video and audio from the smart glasses, as well as the fluoroscopic images, signals recorded on the EP recording system, and the device programmer display. Data were collected on procedure times, complication rates, and feedback from operators on the utility of the technology. Emission savings were estimated by calculating avoided travel for technical staff. Results Over a 3-month period, smart glasses were successfully used to support 30 device implantation procedures, including complex cases (CSP, CRT-D, Leadless pacemakers implants). In two instances, urgent implantation of the Micra leadless pacemaker was performed avoiding the need for a temporary pacemaker in high-infection-risk patients. No increase in procedural and fluoroscopic times was observed, and no complications occurred during any of the procedures. Overall, CO2 emissions associated with the technician’s potential travel were reduced, with an estimated saving of 1.9 tons. Conclusion Smart glasses offer a feasible, safe, and efficient option for remote support during cardiac device implantation, particularly in urgent scenarios. This technology reduces dependence on in-person technician presence, thereby enhancing workflow, potentially reducing emissions, and supporting sustainability efforts in healthcare.Procedure exemple EP lab setting