Abstract
Artificial intelligence (AI) is being intensively applied to cardiology, particularly in diagnostics, risk prediction, treatment planning, and invasive procedures. While AI-driven advancements have demonstrated promise, their real-world implementation remains constrained by critical challenges. Current AI applications, such as electrocardiogram interpretation and automated imaging analysis, have improved diagnostic accuracy and workflow efficiency, yet generalizability, regulatory hurdles, and integration into existing clinical workflows remain major obstacles. Algorithmic bias and the lack of explainable AI further complicate widespread adoption, potentially leading to disparities in healthcare outcomes. In interventional cardiology, robotic-assisted percutaneous coronary intervention has emerged as a technological innovation, but comparative clinical evidence supporting its superiority (or even non-inferiority) over conventional approaches is still limited. Additionally, AI-based decision support systems in high-risk cardiovascular procedures require rigorous validation to ensure safety and reliability. Ethical considerations, including patient data security and region-specific regulatory frameworks, also pose significant barriers. Addressing these challenges requires interdisciplinary collaboration, robust external validation, and the development of transparent, interpretable AI models. This review provides a critical appraisal of the current role of AI in cardiology, emphasizing both its potential and its limitations, and outlines future directions to facilitate its responsible integration into clinical practice.