Echocardiography, the primary tool for the initial evaluation of many cardiac conditions, typically requires the expertise of a cardiologist for accurate interpretation. However, such expertise can be scarce in rural areas and smaller cities. Previous attempts at robotic arm-assisted remote echocardiograms for teleconsultation were mainly restricted to heart failure patients, largely because of delays related to network latency affecting the control of the robotic arms. Now, new research presented at ESC Congress 2024 demonstrates that echocardiograms conducted remotely using a 5G cellular network and robotic arm can match the accuracy of those performed in person by cardiologists.

In a study by researchers from Zhongshan Hospital (Shanghai, China), the utility and diagnostic precision of a remote echocardiographic system, utilizing a 5G network and robotic arm, were evaluated. This system was operated from an outpatient clinic located 20 kilometers away from the hospital. The study included 51 patients from the outpatient cardiology clinic, each of whom underwent a standard comprehensive echocardiography using the 5G-enhanced robotic system and a traditional echocardiographic setup at Zhongshan Hospital. Patients were randomly assigned to be tested with either the remote or conventional systems first, with no time gap between the two tests. Different cardiologists, blind to each other’s findings, performed the examinations, and the cardiologist using the remote system was randomly chosen without specific prior training. Diagnoses were rendered in real-time immediately following each exam. Of the 51 patients, the image quality was deemed diagnostic in 50 cases. Only one patient was excluded due to the inability to capture essential views remotely, resulting in a 98% technical success rate. About a third (17 patients) were diagnosed with cardiac conditions via conventional echocardiography, with various diagnoses including valvulopathy, post-cardiac surgery conditions, hypertrophic cardiomyopathy, abnormal ventricular wall motion, and congenital heart defects.

Remote echocardiography achieved the same diagnostic outcomes as the conventional method in 98% of the cases, missing only one case of obstruction at the papillary muscle level. Remote imaging took notably longer—about 50% more time than conventional methods (24 minutes and 36 seconds vs. 16 minutes and 15 seconds). While previous iterations of this robotic system have been approved for abdominal scans in several regions, the authors recommend conducting larger, multi-center trials before widespread adoption for cardiac use. They note that while 5G technology is not universally available, it could enhance access to specialist cardiac care by reducing the need for patient travel. Additionally, remote echocardiography could offer increased protection for health workers, particularly during pandemics like COVID-19, by minimizing the need for close physical contact.

“Comprehensive echocardiographic exam with a 5G cellular network and robotic arm-based remote system is feasible with relatively good diagnostic accuracy,” said study author Dr. Yu Liu, Zhongshan Hospital. 

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