Table 1.

Overview of VR Studies for Pain and Anxiety Reduction in Cardiac Surgery and Interventional Cardiology by Means of VR Distraction Therapy and Patient Education

Clinical Phase	First Author, Year	Cardiovascular Domain	Study Type	Sample Size (n)	Mean Age (y)	VR Technique	Conclusion of Results
Preprocedural	Hendricks et al, 202024	Cardiac surgery	RCT	20	66.5 ± 8.0	Distraction therapy	Reduced stress (P = 0.001) and anxiety (P = 0.048) in VR group compared to control group
	Pool et al, 202225	Interventional cardiology	RCT	60	43.8 ± 11.0	Patient education	Lower anxiety (P = 0.02) in VR group compared to control group
	Morgan et al, 202126	Interventional cardiology	RCT	64	68.7	Patient education	Lower anxiety (P = 0.03) in VR group compared to control group
	Aardoom et al, 202219	Interventional cardiology	Feasibility	8	67.0 ± 7.5	Patient education	Less anxiety in all subjects after VR session (subjective reporting)
	Keshvari et al, 202127	Interventional cardiology	RCT	60	51.6 ± 4.1	Distraction therapy	Lower anxiety (P ≤ 0.01) in VR group compared to control group
	Chang et al, 202128	Interventional cardiology	RCT trial	33	58.2 ± 8.5	Patient education	Lower anxiety (P ≤ 0.05) in VR group compared to control group
	Hermans et al, 202329	Interventional cardiology	RCT	134	66.3	Patient education	No significant effect of VR on anxiety levels (P = 0.4)
	Pouryousef et al, 202030	Interventional cardiology	RCT	90	50.7 ± 8.1	Distraction therapy	Lower anxiety (P = 0.001) in VR group compared to control groups
	Grab et al, 202331	Cardiac surgery	RCT	99	64.8 ± 10.9	Patient education	No significant effect of VR on anxiety levels (P = 0.76)
Periprocedural	Bruno et al, 202032	Interventional cardiology	RCT	32	83.0 ± 4.8	Distraction therapy	Lower anxiety (P = 0.04) in VR group but no difference in pain (P = 0.61) compared to control group
	Roxburgh et al, 202133	Interventional cardiology	RCT	99	63.8 ± 10.7	Distraction therapy	Lower pain (P = 0.004) in VR group compared to control group
	Mitchell et al, 202034	Interventional cardiology	Case report	1	60	Distraction therapy	The patient reported minimal pain during procedure with VR
	Zablah et al, 202135	Interventional cardiology	Case series	3	14.7 ± 0.5	Distraction therapy	All subjects reported feeling comfortable and minimal pain with VR
Postprocedural	Mosso-Vazquez et al, 201436	Cardiac surgery	Observational	67	Unknown	Distraction therapy	Decrease of pain levels in 88% of all participants after VR session
	Mosso-Vazquez et al, 201337	Cardiac surgery	Observational	22	56.9 ± 10.0	Distraction therapy	Decrease of pain levels in 95% of all participants after VR session
	Cacau et al, 201338	Cardiac surgery	RCT	60	50.6 ± 2.5	Distraction therapy	Lower pain (P ≤ 0.05) in VR group compared to control group after 3 d
	Maciolek et al, 202039	Interventional cardiology	RCT	65	59.8 ± 11.8	Distraction therapy	Lower anxiety (P ≤ 0.05) in VR group compared to control group
	Laghlam et al, 202140	Cardiac surgery	RCT	200	68.0 ± 7.4	Distraction therapy	No significant differences for pain between VR and control group.
	Rousseaux et al, 202241	Cardiac surgery	RCT	100	66.0 ± 11.5	Distraction therapy	No significant differences for pain and anxiety between VR and control group.

RCT = randomized controlled trial; VR = virtual reality.