VR’s Effect on Preprocedural Anxiety Compared With Standard Education

Virtual reality plus standard care does not decrease preprocedural anxiety in patients receiving first cardiac catheterization.

Virtual reality (VR) in addition to standard education does not affect preprocedural anxiety compared with standard education alone among patients receiving cardiac catheterization. These findings were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 held from September 17th through 19th, in Boston, Massachusetts.

Preprocedural anxiety is common among patients receiving cardiac catheterization. To evaluate whether a VR intervention may reduce anxiety levels, patients (N=179) scheduled to receive left heart catheterization, coronary angiography, or both at Spectrum Health in the United States were randomly assigned to receive VR plus standard education (n=89) or standard education alone (n=90). The interventions were delivered less than 1 week prior to the procedures. Standard education was delivered both in-person and over the phone. The VR intervention was delivered using a headset and smartphone and included a true-to-life simulation of the hospital lobby, waiting room, preprocedural nursing area, and procedure room. Anxiety was measured using the State-Trait Anxiety Inventory state score (STAI-S) before randomization and following the intervention.

The study population comprised 63.7% men and was aged mean 63±8 years.

Prior to randomization, average STAI-S scores were 40±12 points among the VR group and 39±11 points among the education group (P =.48). Prior to the procedure, anxiety levels did not differ between the VR (mean, 38) and education only (mean, 38; P =.66) cohorts.

Patients who used the VR device reported disorientation (8.0%), altered vision (5.7%), headache (3.4%), and nausea (3.4%).

The results of this study may not be generalizable to other study populations or for anxiety related with other procedures.

“In the first randomized study to evaluate the impact of VR on preprocedural anxiety, VR did not reduce preprocedural anxiety compared with standard education alone,” the study authors noted. “Future studies are needed to determine if novel applications of VR can enhance patient experience in the catheterization laboratory.”


Ber R, VanOosterhout S, Loo LV, et al. Impact of virtual reality on pre-procedural anxiety prior to heart catheterization: the VR-THEIA study. Presented at: The Transcatheter Cardiovascular Therapeutics Scientific Symposium; September 17-19, 2022; Boston, MA. Abstract #261.