Table 4.

Effects of virtual reality in patients with cardiac diseases.

Outcome category	Outcomes subcategory	Outcomes	Positive effect	No effect	Negative effect
Rehabilitation	Physical	↓ Pain	[26, 45]
		↓ Length of hospitalization	[26, 45]
		↑ METS (metabolic equivalents)	[37, 48]
		↑ OR ↓ heart rate	[16, 38]
		↑ Walking capacity	[45]
		↑ Energy level	[45]
		↑ Physical ability		[45]
		↑ Executive function	[40]
		↑ Respiratory rate	[38]
		↑ Maximum workload	[47]
		↑ Rating of perceived exertion	[38]
		↓ Systolic blood pressure	[16]
		↑ Parasympathetic activity	[26]
		↑ Cardiac autonomic modulation	[26]
		↑ 6MWT	[37]	[31]
		↑ Ergometry	[37]
		↓ Total fat	[41]
		↓ Waist-to-hip ratio	[41]
		↑ High-density lipoprotein cholesterol	[41]
		↑ General health	[37]
		↑ VO2 peak	[48]
		↓ Number of sessions required to reach the target HR and VO2	[47]
	Psychological	↓ Stress level	[24, 25, 29, 30]	[40]
		↓ Emotional tension	[24, 25, 29, 30]	[45]
		↓ HADS total score	[24, 25, 29, 30]
		↓ Anxiety	[16, 24, 25, 36]	[28, 40]
		↓ Depression	[25, 29, 30, 37]	[40]
		↑ Quality of life		[40]
		↑ Selective attention	[40]
		↑ Conflict resolution ability	[40]
		↓ Feeling of pain			[28]
		↑ Satisfaction	[37]	[31]	[28]
		↑ Adherence	[32]
		↑ Engagement		[31]	[32]
		↑ Motivation			[32]
		↑ Knowledge retention		[31]
		↑ Social function	[37]	[45]
		↑ Vitality	[37]
Training and education	ACLS training	↑ Performance	[44]
		↑ Technical skill			[35]
		↑ Providing high-quality education			[35]
		↑ Delivering feedback			[35]
		↑ Easiness	[35]
		↑ Cost-effective	[35]
	AF preprocedural education	↑ Familiarity	[33]
		↓ Anxiety	[33]
		↑ Self-efficacy	[33]
		↑ Confidence	[33]
		↑ Post-procedure self-monitoring-related knowledge	[33]
		↑ General satisfaction	[33]
		↓ Pain	[33]
		↓ Impatience	[33]
	Anatomy education	↑ Understanding of cardiac anatomy	[27, 39]
		↑ Enjoyment	[39]
		↑ Level of knowledge	[34]	[27]
		↑ Subjects' impression of the ease of use	[27]
	Cardiac catheterization training	↑ Technical performance	[46]
		↑ Global performance	[46]
		↑ Skills score	[42]
	Robotic cardiac surgery training	↑ Proficiency scores	[43]
		↑ Speed of internal thoracic artery harvest	[43]
		↑ Speed of mitral annuloplasty	[43]