Novel tools and techniques are provided for implementing intelligent assistance (“IA”) or extended intelligence (“EI”) ecosystem to placement procedures for cardiac implantable electronic device (“CIED”). In various embodiments, a computing system might analyze received one or more first layer input data (i.e., room content-based data) and received one or more second layer input data (i.e., patient and/or tool-based data), and might generate one or more recommendations for guiding a medical professional in performing a CIED placement procedure in a heart of the patient, based at least in part on the analysis, the generated one or more recommendations comprising 3D or 4D mapped guides toward, in, and around the heart of the patient. The computing system might then generate one or more XR images, based at least in part on the generated one or more recommendations, and might present the generated one or more XR images using a UX device.