Our future goal:
Fusion Imaging with Artificial Intelligence in the Cloud


CART-Tech solution for CRT Implants

CARTBox for CRT; easy assessment and visualization of:

    • 3D myocardial infarction transmurality map
    • 4D myocardial contraction dyssynchrony map
    • Visualization of the AHA 17 segment model
    • Overlay of all information on live fluoroscopy during the device implantation
    • CE certified (currently without cloud functionality)

Clinical evidence

Patients who received real-time image-guided LV lead implantation using CARTBox had their lead placed much closer to the target area compared to patients who received the lead without guidance by CARTBox (8 mm [IQR 0–22] vs 26 mm [IQR 17–46], p = 0.04). They also had marked LV reverse remodelling at 6 months follow up with a mean LVESV change of −30 ± 10% and a mean LVEF improvement of 15 ± 5%.
Conclusion: real-time image-guided LV lead implantation is safe and feasible and may prove useful for achieving the optimal LV lead position.

CARTBox: personalized CRT in three steps

    • Upload: Gold standard cardiac MRI
    • Cloud: Computational analysis by Artificial Analysis
    • Output: patient Pre-intervention Report and dataset for fusion/visualization during cardiology procedure.

CARTBox MRI image overlays

Project myocardial infarction transmurality and contraction dyssynchrony on live fluoroscopy.


    CART-Tech philosophy:

    • Processing prior to implantation in the cloud, no extra time required during the procedure
    • Vendor-independent, compatible with old and new equipment
    • Augment the skills of the cardiologist.

    The future:

    • New therapeutic areas
    • Fusion of myocardial infarction imaging with mapping devices (CARTO, Ensite-NavX) to support ventricular ablation procedures
    • Use of CT imaging

    Mapping mechanical contraction

    Clinical development

    Currently, CART-Tech is conducting a large randomized study together with several leading clinical centers, supported by ZonMw (The Netherlands Organisation for Health Research and Development):

    Co-ordinating center:
    UMC Utrecht
    Principle investigator: Mathias Meine, MD, PhD

    Co-investigator: Philippe Wouters, MD
    Antonius Ziekenhuis, Nieuwegein
    Principle Investigator: Vincent van Dijk, MD, PhD

    Isala Ziekenhuis, Zwolle
    Principle Investigator: Peter Paul Delnoy, MD, PhD
    Additional clinical studies will be added in the near future.


    Philippe Wouters MD MSc

    PhD-candidate UMC Utrecht

    Philippe has a background in biomedical sciences, where his first interest in cardiovascular research was sparked. Afterwards he obtained a double master’s degree in both medicine and clinical research. Since 2019, Philippe is working as a PhD-candidate in UMC Utrecht. He investigates various strategies to improve response to cardiac resynchronization therapy. His main focus is to improve lead positioning in this important device therapy. Philippe believes in the importance of a holistic and multidisciplinary approach, and is therefore also involved in resolving knowledge gaps within the field of exercise physiology in patients with chronic heart failure.