The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Virtual reality assisted conscious sedation during transcatheter aortic valve implantation – a randomized pilot study

DOI: 10.4244/EIJ-D-20-00269

1. Universitatsklinikum Dusseldorf, Cardiology, Pneumology and Angiology, Düsseldorf, Germany
2. Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Germany
3. Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Germany ; Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany
4.Universitatsklinikum Dusseldorf, Cardiology, Pneumology and Angiology, Düsseldorf, Germany
Aims
Virtual Reality (VR) has been used successfully in different clinical settings to treat anxiety. This prospective, randomized pilot study investigates the feasibility and safety of VR in patients undergoing conscious sedation during transfemoral transcatheter aortic valve implantation (TAVI).
Methods and results
Thirty-two patients were included and randomized to VR intervention (n=16) or control (n=16). In the intervention group, patient-selected relaxing 3D-Videos were projected during the TAVI procedure; pain and anxiety before and after TAVI were measured using visual analog scales (VAS, 0-10). The median age was 83 years (IQR 78.25-87). Patients’ baseline characteristics did not differ significantly between groups. During TAVI under conscious sedation, the median duration of VR intervention was 30.5 minutes (IQR 23.5-46). 81.3% of the patients watched the videos until device implantation, 37.5% during the whole procedure. The VR-intervention group reported significantly less anxiety after the procedure (VAS 2 (IQR 0-3.75) vs. 5 (IQR 2-8), p=0.04) than patients randomized to control. 93.8% of the intervention group would use VR during TAVI again. Nausea and vomiting did not occur more frequently compared to control.
Conclusions
VR-interventions during TAVI to assist conscious sedation are safe and feasible, even in very old and frail patients. In this small cohort, there was a significant reduction in periprocedural anxiety.

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