Virtual reality-assisted conscious sedation during transcatheter aortic valve implantation: a randomised pilot study

Bruno, Raphael Romano; Lin, Yingfeng; Wolff, Georg; Polzin, Amin; Veulemans, Verena; Klein, Kathrin; Westenfeld, Ralf; Zeus, Tobias; Kelm, Malte; Jung, Christian

doi:10.4244/eij-d-20-00269

Cited by 34 publications

(56 citation statements)

References 21 publications

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“…While the patient receives visual signals informing him or her that he or she is moving, no corroborating information is provided by the vestibular organs. Cybersickness has been described to occur in 20% to 80% of cases [ 29 ], although it occurred in only 18.8% of the sample in Bruno et al’s [ 17 ] study. In our study, the occurrence of this side effect was even lower (6.3%) and may be due to younger age, fewer comorbidities, and better hemodynamic stability in patients undergoing AF ablation compared to those who underwent the transcatheter aortic valve implantation procedure.…”

Section: Discussionmentioning

confidence: 99%

“…While in cardiology, the majority of devices are intended to monitor heart rhythm, others have a therapeutic purpose [8][9][10]. One such device, the virtual reality headset, is the subject of numerous studies [11][12][13][14][15] and has recently shown to improve analgesia in a small sample of patients undergoing transcatheter aortic valve implantation [16,17]. To our knowledge, this device has not been tested in other cardiac procedures.…”

Section: Introductionmentioning

confidence: 99%

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Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Roxburgh¹,

Li²,

Guenancia³

et al. 2021

J Med Internet Res

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Background Connected devices are dramatically changing many aspects in health care. One such device, the virtual reality (VR) headset, has recently been shown to improve analgesia in a small sample of patients undergoing transcatheter aortic valve implantation. Objective We aimed to investigate the feasibility and effectiveness of VR in patients undergoing atrial fibrillation (AF) ablation under conscious sedation. Methods All patients who underwent an AF ablation with VR from March to May 2020 were included. Patients were compared to a consecutive cohort of patients who underwent AF ablation in the 3 months prior to the study. Primary efficacy was assessed by using a visual analog scale, summarizing the overall pain experienced during the ablation. Results The AF cryoablation procedure with VR was performed for 48 patients (mean age 63.0, SD 10.9 years; n=16, 33.3% females). No patient refused to use the device, although 14.6% (n=7) terminated the VR session prematurely. Preparation of the VR headset took on average 78 (SD 13) seconds. Compared to the control group, the mean perceived pain, assessed with the visual analog scale, was lower in the VR group (3.5 [SD 1.5] vs 4.3 [SD 1.6]; P=.004), and comfort was higher in the VR group (7.5 [SD 1.6] vs 6.8 [SD 1.7]; P=.03). On the other hand, morphine consumption was not different between the groups. Lastly, complications, as well as procedure and fluoroscopy duration, were not different between the two groups. Conclusions We found that VR was associated with a reduction in the perception of pain in patients undergoing AF ablation under conscious sedation. Our findings demonstrate that VR can be easily incorporated into the standard ablation workflow.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Roxburgh¹,

Li²,

Guenancia³

et al. 2021

J Med Internet Res

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“…VRH as an adjunctive tool in the alleviation of the patient's pain and anxiety in a catheterization lab setting is seldomly used [8]. Our work analyses the potential use of VRH as an adjunctive therapy in patients undergoing interventional procedures in an electrophysiology laboratory.…”

Section: Discussionmentioning

confidence: 99%

“…In the field of interventional cardiology, potential interest has been demonstrated in VRH during transcatheter aortic valve replacement (TAVR) procedures [8]. Electrophysiological (EP) procedures and cardiac electronic device implantation can generate the same mindset in patients and are mostly performed under conscious sedation.…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality Hypnosis in the Electrophysiology Lab: When Human Treatments Are Better than Virtual Ones

Coulibaly

Cardelli

Moulis

et al. 2022

JCM

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Aims: Virtual reality hypnosis (VRH) has been used successfully in various clinical settings to decrease anxiety and the sensation of pain. We aimed to investigate the feasibility and safety of VRH in patients undergoing electrophysiology and pacing procedures under conscious sedation. Methods: During a two-month period, VRH support was proposed and accepted by 25 patients undergoing electrophysiological procedures. Data were compared with a control group (n = 61) enrolled during the following three-month period. Both groups underwent the measurement of the duration of intervention, the consumption of analgesics and hypnotics, and their pain and comfort using a validated visual analogue scale (VAS 0−10). Results: The baseline characteristics were comparable in both groups, including age. There were no differences in procedure duration (46 (±29) vs. 56 (±32) min, p = 0.18) or in hypnotic/antalgic consumption (midazolam 1.95 (±1.44) vs. 2.00 (±1.22) mg, p = 0.83; sufentanyl 3.78 (±2.87) vs. 3.58 (±2.48) μg, p = 0.9) between the control and VRH groups. In a multivariate analysis, the use of VRH was independently associated with lower comfort during the procedure assessed by postoperative visual analogue scale (OR 15.00 [95% CI 4.77−47.16], p < 0.01). There was no influence of VRH use on pain or drug consumption. Conclusions: In our experience, compared with VRH, human care is preferable during procedures in electrophysiology lab to improve the comfort of the patient. VRH has no influence on pain or drug consumption.

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“…Using VR can cause a syndrome called "cyber sickness", where people experience headaches, nausea and vomiting. Pathologically, this syndrome is probably caused by motion-induced sickness [ 15 ]. Finally, there is no evidence about the risk of VR glasses in patient-to-patient transmission of infections such as multi-drug-resistant pathogens.…”

Section: Persisting Issues In Vr Studiesmentioning

confidence: 99%

Virtual reality in intensive care

et al. 2022

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Virtual reality-assisted conscious sedation during transcatheter aortic valve implantation: a randomised pilot study

Cited by 34 publications

References 21 publications

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

Virtual Reality Hypnosis in the Electrophysiology Lab: When Human Treatments Are Better than Virtual Ones

Virtual reality in intensive care

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