Technology in Cardiovascular Care: Q and A with Dr. Yiannis Chatzizisis

Article Summary
- Dr. Yiannis Chatzizisis spoke about artificial intelligence and regulatory changes at the recent Society of Cardiovascular Computed Tomography (SCCT) annual meeting.
- Dr. Chatzizisis said AI adds speed and precision to cardiac computed tomography.
- Dr. Chatzizisis also said the FDA is receptive to AI-powered software as a medical device.
The Society of Cardiovascular Computed Tomography (SCCT) recently held its annual meeting in Washington, D.C. The University of Miami Miller School of Medicine played a prominent role, particularly Yiannis Chatzizisis, M.D., Ph.D., professor of medicine in the Division of Cardiovascular Medicine at the University of Miami Miller School of Medicine.
Dr. Chatzizisis, also UHealth—University of Miami Health System chief of cardiovascular medicine, contributed to SCCT sessions on artificial intelligence, regulatory changes and trends in cardiovascular care. We spoke with Dr. Chatzizisis about the meeting and how researchers and clinicians are pushing the envelope in cardiac computed tomography.
Tell us about your discussion of artificial intelligence in cardiac CT.

AI is an important technology because it adds insights that augment our own experience. Not everyone is an expert, especially people who are new to the field, so it’s like having an expert on call whenever you need them. Also, it adds consistency, speed and precision to prevention, diagnosis and procedural planning, and speed is always essential.
During the meeting, I co-chaired the AI/ML (artificial intelligence/machine learning) workshop, which discussed how these technologies are being used to enhance cardiac CT.
We started out with basic AI concepts, as well as discussing large language models, such as ChatGPT. We wanted to give people a basis to understand the tools, the mathematics behind what we call AI, and how these technologies have evolved to be integrated into CT analysis.
In cardiovascular care, AI is transforming how we use cardiac CT for prevention, diagnosis and therapy. AI can accelerate data analysis, image segmentation and processing and data extraction. These are all essential to get more information out of these critical scans and can help our patients prevent heart attacks, which is always the primary goal, when possible.
For cardiologists, cardiac CT plays a major role in treatment planning, with AI streamlining and accelerating the process.
Describe the regulatory landscape for these emerging technologies.
I led a session on clinical validation and regulatory approval, where we discussed the FDA’s framework for assessing AI, as well as the barriers to integrating it into cardiac CT workflows.
My main topic was the regulatory pathways at the FDA and the rest of the world and what needs to happen to accelerate cardiovascular AI approval. In the language of the FDA, software is considered a medical device and we talked about where it stands now in terms of FDA clearance.
The FDA is becoming more and more receptive to AI-powered software as a medical device, most of which is being used in radiology. Out of 1,000 software applications approved by the FDA, around 80% are in radiology and about 15% in cardiology, so this has important implications for what we do.
AI adds consistency, speed and precision to prevention, diagnosis and procedural planning, and speed is always essential.
—Dr. Yiannis Chatzizisis
We also discussed cardiac CT data to run in silico clinical trials, which are studies we conduct in the computer using patient data, rather than with actual patients. This is becoming increasingly important because we can collect data from all over the world, and that helps us make clinical trials more diverse, which is crucial to improve care.
Also, in silico trials can accelerate the whole FDA regulatory pathway for cardiovascular devices, moving these technologies into the clinic, where they can really help patients.
Tell us about the SCCT/SCAI session.
I chaired a session with SCCT and the Society for Cardiovascular Angiography & Interventions (SCAI). It was the first time there had ever been an official joint session between the two organizations.
We discussed how we are applying CT to cardiovascular disease, focusing on planning complex coronary procedures, such as chronic total occlusion interventions, in which we repair blocked arteries. Because AI-powered CT can provide subtle information about a person’s anatomy and the coronary issues they face, it is becoming an incredibly important tool to precisely treat each patient’s unique condition.
Tags: AI, artificial intelligence, cardiology, cardiovascular, Dr. Yiannis Chatzizisis, heart attack, heart care, heart disease, technology, USNWR Cardiovascular