Audiovisual distraction reduces sedative requirements and enhances patient satisfaction during mitral transcatheter edge-to-edge repair

Abstract Background Transcatheter mitral-valve repair is increasingly performed under conscious sedation to minimize the risks associated with general anesthesia, particularly in patients with advanced cardiovascular conditions. However, patient discomfort, anxiety, and management of sedation levels can be challenging. Whether audiovisual distraction (AVD) techniques can reduce sedative requirements and enhance patient satisfaction in patients undergoing transcatheter mitral-valve repair is unclear. Methods We conducted a single-center, randomized controlled trial to assess whether AVD with video glasses and headphones can lower the sedation dose needed during mitral transcatheter edge-to-edge repair (M-TEER) and improve the overall procedural experience for patients. Patients were assigned in a 1:1 ration either to inactive video glasses (control group) or active video glasses (AVD group) during M-TEER. The primary outcome was the dosage of administered propofol. Secondary outcomes included procedural time, patient satisfaction (ZUF-8 score), anxiety, and pain levels before and after M-TEER. Results A total of 56 patients undergoing M-TEER underwent randomization: 26 were assigned to the control group and 30 to the AVD group. The AVD group required significantly less propofol (4.6 ± 1.6 mg/kg/h vs. 5.8 ± 1.4 mg/kg/h, p=0.005) and reported higher comfort levels during the procedure. Procedural time did not differ significantly between groups (102.2 ± 36 min vs. 91.0 ± 32.7 min, p=0.24). The ZUF-8 scores indicated a significant increase in patient satisfaction in the AVD group (24.7 ± 3.0 vs. 22.5 ± 3.0, p=0.008). Anxiety levels were significantly lower in the AVD group immediately after the procedure compared with the control group (Numeric Rating Scale , NRS 1.1 ± 1.0 vs. 2.6 ± 1.8; p=0.001). Pain levels remained low in both groups without significant intergroup differences. Conclusion AVD via video glasses effectively reduces sedative requirements and improves patient satisfaction and anxiety management in patients undergoing M-TEER under conscious sedation. 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 interventional cardiology.Audiovisual distraction in M-TEER