Audiovisual Distraction with Video Glasses Reduces Sedative Requirements and Enhances Patient Comfort During Mitral Valve Clipping: A Randomized Controlled Trial

Background: Mitral valve clipping is increasingly performed under conscious sedation to minimize the risks associated with general anesthesia, particularly in patients with advanced cardiovascular conditions. Conscious sedation allows for essential procedural guidance via transesophageal echocardiography and helps ensure patient stillness during the intervention. Despite these advantages, patients often experience discomfort and anxiety, and managing sedation levels can be challenging in this vulnerable population. Audiovisual distraction techniques, such as video glasses, have shown promise in reducing sedative requirements and enhancing patient comfort in various surgical contexts. Therefore, this study explores whether audiovisual distraction with video glasses can lower the sedation dose needed during mitral valve clipping and improve the overall procedural experience for patients.

Methods: We conducted a single-center, randomized controlled trial at the University Heart Center Lübeck. A total of 56 patients undergoing mitral valve clipping were randomized into two groups: Control (inactive video glasses) and Intervention (active video glasses). Baseline characteristics, including age, sex, NYHA class, LV-EF, and comorbidities, were comparable between groups (p > 0.05)(Table 1). The primary outcome was the propofol dose administered. Secondary outcomes included procedural time, patient satisfaction (ZUF-8 score), anxiety, and pain levels before and after clipping.

Results: The Intervention group required significantly less propofol (p < 0.01) (Figure A) and reported higher comfort levels during the procedure (p < 0.0001) (Figure C). Importantly, procedural time did not differ significantly between groups (p > 0.05) (Figure B). Additionally, the ZUF-8 scores indicated a significant increase in patient satisfaction in the Intervention group (p < 0.01) (Figure D). Anxiety levels were significantly lower in the Intervention group after the procedure (p < 0.001) compared with the Control group (Figure E). Pain levels remained low in both groups without significant intergroup differences (Figure F).

Conclusion: Audiovisual distraction via video glasses effectively reduces sedative requirements and improves patient satisfaction and anxiety management in patients undergoing mitral valve clipping. This technique holds potential as a non-invasive adjunct to enhance procedural comfort and reduce pharmacological sedation in interventional cardiology. Further studies with larger samples could provide additional insights into its benefits for patient-centered care in high-risk cardiac interventions.