The Heart of Things

SentiAR's hands-free headset enables surgeons and physicians to see 3D, mixed-reality, real-time images of patients’ hearts.

Work

Story By Ginger O’Donnell
Visuals By R.J. Hartbeck

Jonathan Silva, an professor of biomedical engineering at Washington University in St. Louis, has always been interested in science that improves cardiac health. “There are so many people affected by heart conditions,” he says. “If you can improve care, even marginally, you can really help a lot of people.”

In his research lab at WashU, Silva uses computer modeling and biophysics methods to improve therapies for irregular heart rhythms, or arrhythmia — one of the most prevalent cardiac conditions in the United States, affecting roughly 2% of Americans. In his role as the co-founder and chief technology officer of the startup SentiAR, he supplements this focus on basic science with work that has more direct applications: helping electrophysiologists see better when performing cardiac ablations, a common treatment for arrhythmia. And, another upside — he gets to collaborate with his wife. 

Enter Dr. Jennifer Silva, also a professor at WashU and SentiAR’s co-founder and chief medical officer. A pediatric cardiologist and electrophysiologist, she performs cardiac ablations routinely. With this procedure — of which more than 350,000 are performed in the U.S. each year — she and other doctors insert thin, flexible tubes called catheters into blood vessels and steer them to the heart, then send zaps of heat or cold energy to create small scars around the organ, meant to block its irregular beats. 

SentiAR produces technology enabling physicians to see better in the operating room via 3D, mixed-reality, real-time images of individual patients’ hearts, projected through a hands-free headset.

Through SentiAR, the Silvas are the co-creators of a patented imaging tool called CommandEP — a mixed-reality software that displays a 3D hologram of a patient’s heart via a hands-free headset worn by the cardiologist in the operating room. It is designed to improve surgical accuracy, streamline communication in the OR, as well as integrate, contextualize, and clearly display the large amounts of patient health data generated throughout the procedure. It is currently being piloted at hospitals in Boston, New York, and New Jersey, and the company plans to rapidly expand deployments over the next 24 months.

“The main purpose of CommandEP is to make the electrophysiologist better at their job by allowing them to see more accurately,” Jonathan Silva says. Physician users not only can see better; they can control their display with slight movements of their head. The name “SentiAR” reflects this goal of clarifying and amplifying a full-sensory view: a combination of the Spanish verb “sentir,” which means “to feel,” and the acronym “AR” for “augmented reality.” 

The couple, who have two children, ages 10 and 13, met while working in a lab together when Jennifer Silva was a pediatric cardiology fellow at WashU and Jonathan Silva was a PhD student. The catalyst for further collaboration goes back to 2015 when Jonathan Silva attended a conference hosted by Microsoft. The corporation was unveiling cutting-edge technologies and soliciting input from engineers and scientists on how to best put them to use. These included the company’s HoloLens headset — essentially a computer fastened to the user’s head — and they showed a three-dimensional heart as a sample visual. Silva immediately called his wife, and they began discussing possible applications of the headset in her clinical practice. 

A peek inside SentiAR's offices inside The Royal Sonesta Chase Park Plaza St. Louis, including a computer screen showing one view of a heart chamber through the SentiAR hands-free headset.

Better, more efficient visualization tools are needed in the field of electrophysiology largely due to the constraints of maintaining a sterile operating environment. Traditionally, the physician has their hands on the catheter and must communicate verbally with a team member across the room every time they want to change their view of anatomical images and important health data. This can create inefficiencies and misunderstandings. Jennifer’s firsthand experience with these limitations, and Jonathan’s ability to test new solutions in his lab, pushed the pair to consider how they might improve the procedure for doctors and patients across the nation. 

As the couple began developing 3D-imaging software (they now use the Magic Leap headset), a variety of support systems aided them in translating their innovation into a viable commercial product — and in building a company around the enterprise. “St. Louis has been a great place to start a company,” Jonathan Silva says. “We’ve found very supportive investors. And especially when we were starting, we found a very good community to help us think through how to put together a company. Many different resources helped us make important connections.” 

One was Arch Grants, an organization founded in 2012 that gives St. Louis-based startups up to $100,000 in equity-free capital, as well as access to a local ecosystem of services to help implement and scale their ideas. The latter was particularly important to SentiAR, according to Jonathan Silva, providing access to lawyers, accountants, and other much-needed human resources. The local venture capital community also was generous, with St. Louis investors like Cultivation Capital and BioGenerator contributing early seed funding. 

Jonathan Silva, an associate professor of biomedical engineering at Washington University in St. Louis, and SentiAR co-founder.

Another major early supporter was WashU’s Office of Technology Management, whose leaders encouraged the pair to conceive of their project as something beyond the research realm, which could be patented and commercialized for broader use. Today, Jennifer Silva pays forward these and other lessons learned to other aspiring WashU innovators, serving as the inaugural faculty fellow in entrepreneurship at Washington University School of Medicine in St. Louis. “Where are the gaps in my profession, and how do I fill them? These are really important questions for potential academic entrepreneurs to ask themselves,” she told the medical school in a 2018 interview. 

Further growth and development were made possible when the Silvas recruited Berk Tas to join SentiAR as CEO in 2018. Tas grew up in Turkey and moved to the U.S. for college, studying electrical engineering, physics, and business. This is his first time at the helm of a company, but he brings substantial experience in medical device development and commercialization, as well as an ambitious vision for what SentiAR can become. “We’ve ended up forming a pretty strong team that pools different strengths,” Jonathan Silva says. “Berk is in charge of commercializing and building the thing, I’m in charge of innovating, and Jen brings the medical perspective.” The trio currently is supported by a team of 14 full-time employees, including specialists in engineering, quality control, and operations. 

CEO Berk Tas, pictured here just outside of SentiAR's offices inside The Royal Sonesta Chase Park Plaza St. Louis, joined the startup in 2018.

With this team, CommandEP’s capabilities are poised to expand. New iterations will continue to refine and advance the 3D visualization tools, making the mixed-reality display more dynamic and possibly integrating a voice command capability so electrophysiologists can precisely manipulate the images they need to see at any given moment. Future versions also might include artificial intelligence components that would allow electrophysiologists to consult with a virtual community of physicians in real time. SentiAR’s continued expansion also will involve more end users across the country. 

In many ways, the startup’s story embodies the axiom “think globally, act locally.”  By sticking to their expertise in cardiac health and rooting themselves in St. Louis’ vibrant startup scene, SentiAR has developed a product with potential for far-reaching impact. 

It all stems from the Silvas’ drive and perseverance to translate complex ideas into action, motivated by their desire to improve cardiac health. Now seeing their tech innovation at work in real health care settings, Jonathan Silva emphasizes the challenge and the reward of this task: “Going from the start, where there was no company, no engineers, no quality control, no field reps, to where we are now, where physicians can actually use this new technology in the operating room in a way that makes a difference, this is something really noteworthy.”

Dr. Jennifer Silva, a professor at WashU and SentiAR’s co-founder and chief medical officer.

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