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Virtual Reality for the Management of Pain and Anxiety in Patients Undergoing Implantation of Pacemaker or Implantable Cardioverter Defibrillator: A Randomized Study

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Abstract

Background

The Virtual Reality Headset (VRH) is a device aiming at improving patient’s comfort by reducing pain and anxiety during medical interventions. Its interest during cardiac implantable electronic devices (CIED) implant procedures has not been studied.

Methods

We randomized consecutive patients admitted for pacemaker or Implantable Cardioverter Defibrillator (ICD) at our center to either standard analgesia care (STD-Group), or to VRH (VRH-Group). Patients in the STD-Group received intra-venous paracetamol (1 g) 60 min before the procedure, and local anesthesia was performed with lidocaine. For patients of the VRH-Group, VRH was used on top of standard care. We monitored patients’ pain and anxiety using numeric rating scales (from 0 to 10) at the time of sub-cutaneous pocket creation, and during deep axillary vein puncture. Patient comfort during the procedure was assessed using a detailed questionnaire. Morphine consumption was also assessed.

Results

We randomized 61 patients to STD-Group (n = 31) or VRH-Group (n = 30). Pain and anxiety were lower in the VRH-Group during deep venous puncture (3.0 ± 2.0 vs. 4.8 ± 2.2, p = 0.002 and 2.4 ± 2.2 vs. 4.1 ± 2.4, p = 0.006) but not during pocket creation (p = 0.58 and p = 0.5). Morphine consumption was lower in the VRH-Group (1.6 ± 0.7 vs. 2.1 ± 1.1 mg; p = 0.041). Patients’ overall comfort during procedure was similar in both groups.

Conclusion

VRH use improved pain and anxiety control during deep venous puncture compared to standard analgesia care, and allowed morphine consumption reduction. However, pain and anxiety were similar at the time of sub-cutaneous pocket creation.

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Data Availability

No datasets were generated or analysed during the current study.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France

    Fabien Squara, Jules Bateau, Didier Scarlatti, Sok-Sithikun Bun, Pamela Moceri & Emile Ferrari

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  1. Fabien Squara
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  2. Jules Bateau
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  3. Didier Scarlatti
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  4. Sok-Sithikun Bun
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  5. Pamela Moceri
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  6. Emile Ferrari
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Contributions

F.S and J.B : design, conception. F.S: drafting of the manuscript. F.S, J.B, D.S, S.B : data acquisition, analysis, interpretation. P.M and E.F: interpretation, revision.

Corresponding author

Correspondence to Fabien Squara.

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Ethical Approval

All patients gave informed consent to participate, and IRB approval was obtained. Study was registered to the ANSM under the ID: RCB 2023-A02481-44.

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None for all authors.

Competing Interests

The authors declare no competing interests.

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Squara, F., Bateau, J., Scarlatti, D. et al. Virtual Reality for the Management of Pain and Anxiety in Patients Undergoing Implantation of Pacemaker or Implantable Cardioverter Defibrillator: A Randomized Study. J Med Syst 48, 28 (2024). https://doi.org/10.1007/s10916-024-02039-1

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