ArticleJACC. Advances2026
Audiovisual Distraction During Mitral Transcatheter Edge-to-Edge Repair: A Sedation-Sparing Randomized Trial.
Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundConscious sedation is increasingly used for mitral transcatheter edge-to-edge repair (M-TEER), but balancing patient comfort with sedative-related hemodynamic and neurocognitive risk remains challenging in frail older adults.
objectivesWe investigated whether audiovisual distraction (AVD) with video glasses reduces propofol requirements and improves patient experience during M-TEER performed under conscious sedation.
methodsIn this prospective randomized controlled trial, 60 patients undergoing M-TEER were assigned 1:1 to AVD (video glasses with nature documentaries and headphones) or sham control (identical inactive device). Propofol-based sedation was managed according to a uniform blinded protocol using a pragmatic Richmond Agitation-Sedation Scale target of -2 to -3. The primary endpoint was the mean propofol dose (mg/kg/h). Secondary endpoints included norepinephrine use, anxiety and pain on numerical rating scales, overall patient satisfaction (measured by the German adaptation of the Client Satisfaction Questionnaire), and in-hospital outcomes.
resultsThe mean propofol dose was lower with AVD than control (4.6 ± 1.6 vs 5.9 ± 1.4 mg/kg/h; P = 0.002). Norepinephrine use was numerically lower (0.5 ± 1.1 vs 1.7 ± 3.4 μg/kg/h; P = 0.08). Procedural duration, hemodynamic fluctuations, and hospital length of stay were similar. AVD reduced postprocedural anxiety (1.1 ± 1.0 vs 2.5 ± 1.7; P = 0.001) and improved satisfaction (24.7 ± 3.0 vs 22.5 ± 2.8; P = 0.005). Safety events, including bleeding, pneumonia, conversion to general anesthesia, and clinically documented delirium, were comparable.
conclusionsAVD with video glasses is a safe, pragmatic adjunct to conscious sedation in M-TEER that reduces propofol requirements and improves patient-reported comfort and satisfaction without compromising procedural efficiency or in-hospital safety. (Does audiovisual distraction reduce the need for analgesic sedation and increase patient satisfaction in patients undergoing mitral valve clipping? A randomized controlled trial; DRKS00037370).
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