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Anxiety Reduction in TAVI Using Virtual Reality Trial

Not Applicable
Conditions
Aortic Stenosis, Severe
Anxiety
Interventions
Other: Virtual Reality Immersion
Registration Number
NCT05069987
Lead Sponsor
Erasmus Medical Center
Brief Summary

The ART-VR Trial is an international multi-center, open label, randomized controlled trial evaluating the effect of an immersive VR environment on procedural anxiety in patients undergoing transfemoral aortic valve replacement (TAVR) under local anaesthesia.

Detailed Description

Virtual reality (VR) allows patients to be fully immerged in an engaging, interactive 3D environment. Its applications are broad and include treatment of phobias, stress-disorders, pain reduction. Recently, VR has been adopted in various medical procedures to reduce pre- and per-procedural anxiety. In TAVR, per-procedural VR immersion could potentially reduce patient anxiety leading to increased overall patient satisfaction. However, contemporary large scale, randomized evidence on VR application in TAVR is lacking.

The objective of this trial is to evaluate the effect of an immersive VR environment on procedural anxiety in patients undergoing TAVR under local anaesthesia in a randomized controlled setting. A total of 150 patients with severe aortic stenosis (AS) who undergo transfemoral TAVR under local aneasthesia will be included. The main study endpoint is procedural anxiety assessed on a visual analogue scale (VAS) directly post-procedure.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Age ≥ 18 years
  • Symptomatic severe aortic stenosis
  • Indication for transfemoral TAVI under local anaesthesia per local heart team consensus
  • Patient is able to understand and sign written informed consent
  • Patient speaks Dutch, German or English
Exclusion Criteria
  • Need for emergent TAVI
  • Need for planned concomitant cardiac intervention during index procedure
  • History of TAVI under local anesthesia/conscious sedation
  • Chronic use of benzodiapines, opioids, pregabalin or antidepressants
  • History of opioid use (within 8-30 days prior to randomization)
  • Claustrophobia
  • Any psychiatric illness diagnosed by a psychiatrist or psychologist
  • Blindness or severe visual impairment despite visual aid (glasses, contact lenses)
  • Epilepsy
  • Extensive cognitive impairment (MMSE <21 or as diagnosed by geriatrician)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
VR-immersionVirtual Reality Immersion-
Primary Outcome Measures
NameTimeMethod
Procedural AnxietyImmediately after the TAVR procedure

Procedural anxiety assessed on a visual analogue scale directly post-procedure. Range: 0 (no anxiety) to 10 (worst anxiety).

Secondary Outcome Measures
NameTimeMethod
Change of Anxiety1 day (From directly before the TAVR procedure until directly after the TAVR procedure)

Difference between pre-procedural and post-procedural anxiety visual analogue scale scores

Procedural PainImmediately after the TAVR procedure

Procedural pain assessed on a visual analogue scale directly post-procedure. Range: 0 (no pain) to 10 (worst pain).

Procedural Use of SedativesUp to 1 day (Depending on procedure duration)

Procedural sedative use and dosage. Amount of benzodiazepine used in milligrams

Procedural Use of AnalgesicsUp to 1 day (Depending on procedure duration)

Procedural analgesic use and dosage. Amount of Lidocaine (or equivalent) used in milligrams

Patient Procedural SatisfactionOne day post procedure

Procedural satisfaction assessed after 24hrs using for procedures under regional anaesthesia. Score assessed on a visual analogue scale. Range: 0 (not at all satisfied) to 10 (very satisfied).

Trial Locations

Locations (1)

Erasmus University Medical Center

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Rotterdam, Zuid Holland, Netherlands

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