Image-Based Medical Navigation Systems for Cardiac Interventions: Recent Technological Advances

Abstract Background The application of catheter-based treatments for a growing range of structural heart diseases (SHD) has significantly increased over the past five years, driven by technological advances in medical navigation systems, particularly those based on medical imaging. Multimodal cardiac imaging plays a crucial role in these systems by combining complementary anatomical, morphological, and functional information, thereby increasing diagnostic accuracy and improving the effectiveness of cardiovascular interventions and clinical outcomes. However, multimodal imaging poses challenges, including intermodality misalignment and the need to determine optimal integration methods for data from different imaging modalities. Methods This article reviews the state-of-the-art image-based medical navigation systems used in catheter-based cardiac procedures. The review covers the period from 2019 to 2023 and includes a total of 44 articles. The methodologies in these studies are grouped into six main categories: Image Enhancement and Tracking, Image Fusion and Reconstruction, 3D Modeling/Printing, Extended Reality, and Artificial Intelligence (AI). Results Most studies involve multimodality imaging, combining or transferring information across different modalities. The review emphasizes that current multimodal imaging techniques enhance the accuracy of procedures such as left atrial appendage closure (LAAC), transcatheter aortic valve implantation (TAVI), and catheter ablation therapy. These techniques rely on combinations of imaging modalities such as fluoroscopy, ultrasound, and computed tomography (CT) to enable real-time guidance and precise navigation during minimally invasive interventions. Conclusion By integrating data from multiple sources, these systems improve diagnostic reliability and procedural success, meeting the complex demands of SHD treatment. Despite advances, real-time surgical guidance remains a major challenge, underscoring the need for continued research in this area.