Use of Google Glass in the Electrophysiology Lab

Senthil K. Thambidorai, MD, FHRS, Ajay Sundaraman, MBBS, Ramesh Hariharan, MD University of Texas Health Science at Houston
Senthil K. Thambidorai, MD, FHRS, Ajay Sundaraman, MBBS, Ramesh Hariharan, MD University of Texas Health Science at Houston

Introduction

Google Glass (GG) is a wearable computer with a head-mounted display that is controlled by voice commands and displays information in a smartphone-like, hands-free format.1,2 In this brief article, we describe using this technology during complex electrophysiology (EP) procedures to get an expert second opinion by viewing the electrograms (EGM) and electroanatomic map (EAM) from another sub-specialist on a real-time basis.

Methods

Our main objective was to determine the feasibility of transmitting images and video streaming (EAM, EGM) and receive actionable communication. The physician operator performing the procedure with the Google Glass transmits the images and videos in a password-protected, encrypted avenue to another physician in a remote location onto his computer or smartphone (Figure 1).

Results

Using Google Glass, we transmitted the images and videos of five simulated cases from the EP lab at Houston Northwest Hospital to a laptop at the UTH outpatient clinic, where it was interpreted by a second EP physician: 

  1. Atrial flutter ablation: Identified EGM and gap in EAM with ridge.
  2. Atrial tachycardia ablation: Identified EGM and EAM showing need for left-sided mapping.
  3. Biventricular defibrillator placement: Able to visualize coronary sinus venogram, branches and the ideal left ventricular lead type needed.
  4. Ventricular tachycardia ablation: Identified EGM mid-diastolic potentials and EAM showing areas of ablation.
  5. Premature ventricular contraction ablation: Identified ECG, EGM tracings for early vs late and EAM map showing potential areas of further ablation.

Conclusions

Use of Google Glass in the EP lab demonstrated that we were able to maintain a hands-free format as well as obtain an expert second opinion and actionable communication, proving its feasibility during EP cases. Currently there is no such mechanism available other than recording and beaming live directly, but this involves a costly infrastructure and lacks the mobility of using it in multiple hospitals. Google Glass has implications for telemedicine and advancing medical education. 

Disclosure: The authors have no conflicts of interest to report regarding the content herein. 

References

  1. Bilton, Nick. Behind the Google Goggles, Virtual Reality. The New York Times. Published February 23, 2012. Available online at http://www.nytimes.com/2012/02/23/technology/google-glasses-will-be-powered-by-android.html?_r=0. Accessed April 4, 2012.
  2. Baum, Stephanie. Surgeon uses Google Glass in the OR to share endoscopic surgery. MedCity News. Published June 24, 2013. Available online at http://medcitynews.com/2013/06/google-glass-in-the-operating-room-adds-to-telemedicines-potential/. Accessed April 4, 2014.