Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France.
Cardiology Clinical Academic Group, St George's, University of London, London, United Kingdom.
J Med Internet Res. 2021 May 27;23(5):e26349. doi: 10.2196/26349.
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.
We aimed to investigate the feasibility and effectiveness of VR in patients undergoing atrial fibrillation (AF) ablation under conscious sedation.
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.
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.
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.
联网设备正在极大地改变医疗保健的许多方面。最近，一种这样的设备——虚拟现实（VR）耳机，已经被证明可以在一小部分接受经导管主动脉瓣植入术的患者中改善镇痛效果。
我们旨在调查 VR 在接受清醒镇静下心房颤动（AF）消融术的患者中的可行性和有效性。
所有在 2020 年 3 月至 5 月期间接受 VR 辅助 AF 消融术的患者均被纳入研究。将这些患者与研究前 3 个月接受 AF 消融术的连续队列患者进行比较。主要疗效评估采用视觉模拟评分法（VAS），总结消融过程中患者总的疼痛感受。
48 例患者（平均年龄 63.0±10.9 岁；女性占 33.3%，n=16）接受了 AF 冷冻消融术并使用了 VR。虽然有 14.6%（n=7）的患者提前终止了 VR 治疗，但没有患者拒绝使用该设备。VR 耳机的准备时间平均为 78（SD 13）秒。与对照组相比，VR 组的平均疼痛感知（VAS）评分更低（3.5[SD 1.5] vs 4.3[SD 1.6]；P=0.004），舒适度更高（7.5[SD 1.6] vs 6.8[SD 1.7]；P=0.03）。然而，两组患者的吗啡用量无差异。最后，两组患者的并发症、手术和透视时间也无差异。
我们发现 VR 可降低接受清醒镇静下 AF 消融术患者的疼痛感知。我们的研究结果表明，VR 可以很容易地整合到标准消融工作流程中。
