This study investigated whether virtual reality (VR) can reduce pain and anxiety in patients undergoing coronary angiography. Coronary angiography is a common cardiac procedure performed under local anesthesia while patients remain awake, which can cause significant pain and anxiety.

Adult patients scheduled for elective coronary angiography were randomly assigned to two groups: one group watched a nature-themed VR video during the procedure, while the control group received standard care. Pain and anxiety levels were measured before and after the procedure using validated scales.

The findings of this study may help healthcare providers offer a simple, non-pharmacological method to improve patient comfort during coronary angiography.

Coronary angiography is one of the most frequently performed invasive cardiac diagnostic procedures. Although the procedure is performed under local anesthesia, patients remain conscious throughout, and procedural pain and anxiety are commonly reported. Non-pharmacological interventions to manage these symptoms are increasingly being explored as adjuncts to standard care.

Virtual reality (VR) is an immersive technology that engages the user's visual and auditory senses, potentially distracting patients from procedural discomfort. This randomized controlled trial examined the effect of VR on pain and anxiety in patients undergoing elective coronary angiography.

Patients were randomized into two groups using a sealed envelope method. The VR group watched a pre-selected nature-themed video through a VR headset throughout the procedure. The control group received standard care without any additional intervention. Pain was assessed using the Visual Analog Scale (VAS) and anxiety was measured using the State-Trait Anxiety Inventory (STAI) before and after the procedure.

The study was conducted at a cardiology unit in Istanbul, Turkey, and was approved by the institutional ethics committee (Approval No: 2019-84). Written informed consent was obtained from all participants prior to enrollment.

Inclusion Criteria:

• Aged 18 years or older
• Scheduled for elective coronary angiography
• Conscious and oriented
• Able to communicate verbally
• No prior coronary angiography experience
• Willing to participate and provided written informed consent

Exclusion Criteria:

• History of psychiatric disorder or use of psychiatric medication
• Visual or hearing impairment that would prevent VR use
• Hemodynamic instability
• Emergency coronary angiography
• Inability to complete the questionnaires
• Prior experience with virtual reality