AI-Guided Echocardiography for Transseptal Puncture

Many procedures used to treat heart rhythm problems and other heart conditions involve passing a fine needle or catheter from one side of the heart to the other, through the thin wall that separates them. This is called a transseptal puncture. To do this safely, doctors use a live ultrasound camera, usually placed in the food pipe under general anaesthetic, to see inside the heart in real time.

These ultrasound images are essential for safe and successful procedures, but interpreting them requires significant expertise and the imaging specialist must remain in the procedure room throughout. Image quality varies between patients and between operators, and staff are exposed to scattered X-rays from the imaging equipment used alongside the ultrasound. There are also too few trained imaging specialists to meet demand, which can delay or cancel procedures.

This project will develop a computer programme — an artificial intelligence (AI) tool — that can automatically recognise the parts of the heart shown on these ultrasound images and track the medical instruments used during the procedure. To train this tool, we will use approximately 100 ultrasound recordings from procedures that have already taken place at Guy's and St Thomas' Hospitals. All recordings will have identifying information removed (pseudonymisation) before any analysis, with the identifying key held securely within Guy's and St Thomas' and never shared outside the Trust. The work will be carried out within the secure data environment of the King's College London and AI Centre programme.

We are working with Laza Medical, a US company specialising in medical imaging AI. Laza brings prior experience of developing AI tools that automatically obtain heart ultrasound views and offers the technical capability and equipment investment needed to take this work toward eventual clinical use. The work has been discussed with the BMEIS public involvement group, who supported the project and provided detailed feedback on transparency, oversight, and ongoing public involvement.