Decreasing Patient Anxiety During Percutaneous Revascularization of Chronic Total Coronary Occlusions Using Virtual Reality Glasses.

Percutaneous coronary intervention (PCI) on chronic total occlusions (CTO) represents one of the greatest challenges in interventional cardiology, due to the complexity of these procedures and the increased risk of complications. In recent decades, advances in techniques and devices have made it possible to obtain better results while reducing the associated complications.

The possibility of performing these procedures without anesthesia or sedation avoids the risks derived from these, but, on the contrary, subjects the patient to pain and anxiety during the procedure. Several factors influence patient anxiety: long duration of procedures, patient immobility (especially in biradial access), monotonous and hostile environment (operating rooms or catheterization rooms). Anxiety and pain are treated by pretreatment with oral benzodiazepines supplemented by opioids or intravenous benzodiazepines on demand during the procedure, assuming the possible complications derived from this treatment.

Virtual reality (VR) has been used successfully in several clinical settings to reduce intra-procedural anxiety. A reduction in anxiety and pain has been demonstrated even in elderly patients undergoing percutaneous aortic valve replacement. Its use does not require technical expertise or experience in the use of digital devices and does not increase the sensation of dizziness or nausea.

The aim of this study is to determine whether the use of a VR system in PCI procedures over CTO decreases the level of anxiety and pain during the procedure.

Method