{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T16:23:35Z","timestamp":1794673415793,"version":"4.9.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus L\u00fcbeck","id":[{"id":"https:\/\/ror.org\/01tvm6f46","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Interv Card Electrophysiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Balloon-in-basket pulsed field ablation (BiB-PFA) enables atrial fibrillation (AF) ablation under conscious sedation (CS). While augmented reality (AR) has been proposed to improve patient comfort during invasive procedures, its benefit in an already well-tolerated awake ablation setting remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of adjunctive AR glasses on sedation requirements and patient comfort during BiB-PFA performed under CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, single-center study, 50 patients undergoing AF ablation with BiB-PFA were treated under a standardized CS protocol. Patients were allocated to either ablation without AR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) or ablation with adjunctive AR glasses (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925). Sedation requirements and patient-reported outcomes were assessed during ablation, as well as at 1-hour and 1-day post-procedure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable. All procedures were completed without conversion to deep sedation. Fentanyl requirements were lower in AR-group (1.1 vs. 1.4\u00a0\u00b5g\/kg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), while other sedatives were similar. Intraprocedural pain was moderate and comparable. AR enhanced perceived calming effect (10.0 vs. 8.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). Satisfaction was high in both groups. Recommendation scores were high overall, with higher values without AR (90(90,100) vs. 90 (70,90);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023). Retrospective anxiety at day 1 remained low but was higher with AR (2.0(0.0,5.0) vs. 0.0 (0.0,0.0);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Pain decreased over time in both (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CS for BiB-PFA is feasible and well tolerated. Intraprocedural pain was low, while satisfaction and recommendation were high in both groups, with slightly higher values without AR support. AR use was associated with modest reduced opioid requirements, suggesting a potential role in selected patients. Slightly higher retrospectively reported anxiety at 1\u00a0day in AR-group, while overall low, warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10840-026-02372-0","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T08:13:03Z","timestamp":1781943183000},"page":"2743-2753","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cAwake but elsewhere\u201d: impact of augmented reality glasses on conscious sedation in balloon-in-basket pulsed field ablation"],"prefix":"10.1007","volume":"69","author":[{"given":"Roland Richard","family":"Tilz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan-Per","family":"Wenzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Eitel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorin","family":"Popescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirco","family":"K\u00fcchler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Mamaev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zgjim","family":"Avdimetaj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Ukita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl-Heinz","family":"Kuck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sascha","family":"Hatahet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"},{"role":"corresponding-author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"2372_CR1","doi-asserted-by":"publisher","first-page":"euae134","DOI":"10.1093\/europace\/euae134","volume":"26","author":"K-RJ Chun","year":"2024","unstructured":"Chun K-RJ, Miklav\u010di\u010d D, Vlachos K, et al. State-of-the-art pulsed field ablation for cardiac arrhythmias: ongoing evolution and future perspective. Europace. 2024;26:euae134.","journal-title":"Europace"},{"key":"2372_CR2","doi-asserted-by":"publisher","first-page":"euaf072","DOI":"10.1093\/europace\/euaf072","volume":"27","author":"RR Tilz","year":"2025","unstructured":"Tilz RR, Chierchia GB, Gunawardene M, et al. Safety and effectiveness of the first balloon-in-basket pulsed field ablation system for the treatment of atrial fibrillation: VOLT CE Mark Study 6-month results. Europace. 2025;27:euaf072.","journal-title":"Europace"},{"key":"2372_CR3","doi-asserted-by":"publisher","first-page":"2524","DOI":"10.1016\/j.hrthm.2025.04.037","volume":"22","author":"M Lo","year":"2025","unstructured":"Lo M, Gambhir A, Sundaram S, et al. Safety and effectiveness of a novel balloon-in-basket pulsed-field ablation catheter for the treatment of paroxysmal and persistent AF: Volt-AF IDE trial acute results. Heart Rhythm. 2025;22:2524\u201333.","journal-title":"Heart Rhythm"},{"key":"2372_CR4","doi-asserted-by":"crossref","unstructured":"Wenzel J-P, Hatahet S, Abdessadok R et al. Differential inflammatory and myocardial biomarker response after pulsed field ablation for atrial fibrillation using balloon-in-basket versus pentaspline catheter. Heart Rhythm O2 2025:S2666501825004477.","DOI":"10.1016\/j.hroo.2025.09.003"},{"key":"2372_CR5","doi-asserted-by":"publisher","first-page":"1681098","DOI":"10.3389\/fcvm.2025.1681098","volume":"12","author":"J-P Wenzel","year":"2025","unstructured":"Wenzel J-P, Abdessadok R, Hatahet S, et al. Balloon vs. balloon\u2014comparison of hemolysis and renal markers after cryoballoon vs. ballon-in-basket pulsed field pulmonary vein isolation. Front Cardiovasc Med. 2025;12:1681098.","journal-title":"Front Cardiovasc Med"},{"key":"2372_CR6","doi-asserted-by":"crossref","unstructured":"Wenzel J-P, Abdessadok R, Eitel C et al. Catheter design matters: Hemolysis and renal function after pulsed field ablation with balloon-in-basket vs. pentaspline systems. J Interv Card electrophysiol [Internet] 2025 [cited 2025 Oct 10];. Available from: https:\/\/link.springer.com\/10.1007\/s10840-025-02152-2","DOI":"10.1007\/s10840-025-02152-2"},{"key":"2372_CR7","doi-asserted-by":"crossref","unstructured":"Wenzel J-P, Hatahet S, Eitel C et al. Inflammatory and myocardial biomarker response following pulmonary vein isolation: Cryoballoon versus balloon-in-basket pulsed field ablation. J Cardiovasc Electrophysiol 2025.","DOI":"10.1093\/europace\/euag105.119"},{"key":"2372_CR8","doi-asserted-by":"crossref","unstructured":"Tilz RR, Wenzel J-P, Eitel C et al. Awake and ablated: First experience with a balloon-in-basket PFA system without propofol. Heart Rhythm O2 2025:S2666501825005574.","DOI":"10.1016\/j.hroo.2025.11.011"},{"key":"2372_CR9","doi-asserted-by":"publisher","first-page":"843","DOI":"10.3390\/jcm12030843","volume":"12","author":"R Hitching","year":"2023","unstructured":"Hitching R, Hoffman HG, Garcia-Palacios A, et al. The emerging role of virtual reality as an adjunct to procedural sedation and anesthesia: A Narrative Review. JCM. 2023;12:843.","journal-title":"JCM"},{"key":"2372_CR10","first-page":"101483","volume":"44","author":"J Zako","year":"2025","unstructured":"Zako J, Daccache N, Morisson L, Richeb\u00e9 P, Laferri\u00e8re-Langlois P. Virtual reality for reduction of intraprocedural pharmacological sedation and analgesia in adult patients: A systematic review and meta-analysis. Anaesth Crit Care Pain Med. 2025;44:101483.","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2372_CR11","doi-asserted-by":"publisher","first-page":"e1014","DOI":"10.4244\/EIJ-D-20-00269","volume":"16","author":"RR Bruno","year":"2020","unstructured":"Bruno RR, Lin Y, Wolff G, et al. Virtual reality-assisted conscious sedation during transcatheter aortic valve implantation: a randomised pilot study. EuroIntervention. 2020;16:e1014\u201320.","journal-title":"EuroIntervention"},{"key":"2372_CR12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1001\/jama.2024.21972","volume":"333","author":"World Medical Association","year":"2025","unstructured":"World Medical Association. World medical association declaration of Helsinki: Ethical principles for medical research involving human participants. JAMA. 2025;333:71\u20134.","journal-title":"JAMA"},{"key":"2372_CR13","doi-asserted-by":"crossref","unstructured":"Tilz RR, Ukita K, Eitel C, Kuck K-H, Hatahet S, Wenzel J-P. How to isolate the superior vena cava using balloon-in-basket pulsed field ablation system: Standardized workflow and initial results. Heart Rhythm O2 2026:S2666501826000267.","DOI":"10.1016\/j.hroo.2026.01.014"},{"key":"2372_CR14","doi-asserted-by":"crossref","unstructured":"Tilz RR, Hatahet S, Eitel C et al. Pulmonary vein isolation using a novel balloon-in-basket pulsed field ablation system: The L\u00fcbeck how-to protocol. Heart Rhythm O2 2026:S266650182600098X.","DOI":"10.1016\/j.hroo.2026.02.022"},{"key":"2372_CR15","doi-asserted-by":"publisher","first-page":"1733642","DOI":"10.3389\/fcvm.2026.1733642","volume":"13","author":"S Hatahet","year":"2026","unstructured":"Hatahet S, Popescu S, Eitel C, et al. Biomarker response to balloon-in-basket pulsed field ablation: does posterior wall isolation matter? Front Cardiovasc Med. 2026;13:1733642.","journal-title":"Front Cardiovasc Med"},{"key":"2372_CR16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s12181-023-00658-5","volume":"18","author":"RR Tilz","year":"2024","unstructured":"Tilz RR, Busch S, Chun KRJ, et al. Analgosedierung in der Kardiologie: Konsensuspapier der DGK und DGAI 2024. Kardiologie. 2024;18:187\u201399.","journal-title":"Kardiologie"},{"key":"2372_CR17","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1213\/ANE.0000000000003699","volume":"129","author":"S Clivio","year":"2019","unstructured":"Clivio S, Putzu A, Tram\u00e8r MR. Intravenous lidocaine for the prevention of cough: Systematic review and meta-analysis of randomized controlled trials. Anesth Analg. 2019;129:1249\u201355.","journal-title":"Anesth Analg"},{"key":"2372_CR18","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1093\/bja\/aew101","volume":"116","author":"S Weibel","year":"2016","unstructured":"Weibel S, Jokinen J, Pace NL, et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016;116:770\u201383.","journal-title":"Br J Anaesth"},{"key":"2372_CR19","doi-asserted-by":"publisher","first-page":"2312","DOI":"10.3390\/jcm12062312","volume":"12","author":"D Gajniak","year":"2023","unstructured":"Gajniak D, Mendrala K, Cyzowski T, Polak M, Gierek D, Krzych \u0141J. Efficacy of lidocaine infusion in high-risk vascular surgery\u2014a randomized, double-blind, placebo-controlled single-center clinical trial. JCM. 2023;12:2312.","journal-title":"JCM"},{"key":"2372_CR20","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1016\/j.pain.2011.07.005","volume":"152","author":"MA Ferreira-Valente","year":"2011","unstructured":"Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152:2399\u2013404.","journal-title":"Pain"},{"key":"2372_CR21","doi-asserted-by":"publisher","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","volume":"45","author":"IC Van Gelder","year":"2024","unstructured":"Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024;45:3314\u2013414.","journal-title":"Eur Heart J"},{"key":"2372_CR22","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1038\/s41591-024-03114-3","volume":"30","author":"E Ekanem","year":"2024","unstructured":"Ekanem E, Neuzil P, Reichlin T, et al. Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study. Nat Med. 2024;30:2020\u20139.","journal-title":"Nat Med"},{"key":"2372_CR23","doi-asserted-by":"publisher","first-page":"2039","DOI":"10.1093\/europace\/euab154","volume":"23","author":"R Garcia","year":"2021","unstructured":"Garcia R, Waldmann V, Vanduynhoven P, et al. Worldwide sedation strategies for atrial fibrillation ablation: current status and evolution over the last decade. Europace. 2021;23:2039\u201345.","journal-title":"Europace"},{"key":"2372_CR24","doi-asserted-by":"crossref","unstructured":"Chun KRJ, Plank K, Neven K et al. Characterization of sedation strategies in real-world use of pulsed field ablation Sub-analysis of the EU-PORIA registry. Europace 2025:euaf287.","DOI":"10.1093\/europace\/euaf287"},{"key":"2372_CR25","doi-asserted-by":"crossref","unstructured":"Calvert P, Mills MT, Murray B et al. Feasibility of pulsed field ablation for atrial fibrillation under mild conscious sedation. J Interv Card Electrophysiol 2024.","DOI":"10.1007\/s10840-024-01961-1"},{"key":"2372_CR26","doi-asserted-by":"crossref","unstructured":"Bolhuis RE, Bax IN, Van Dijk VF et al. Pulsed field ablation for atrial fibrillation with a balloon-in-basket system under conscious sedation: A retrospective feasibility and safety analysis. Heart Rhythm 2026:S1547527126001293.","DOI":"10.1016\/j.hrthm.2026.02.011"}],"container-title":["Journal of Interventional Cardiac Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10840-026-02372-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10840-026-02372-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10840-026-02372-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T06:50:58Z","timestamp":1794639058000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10840-026-02372-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2372"],"URL":"https:\/\/doi.org\/10.1007\/s10840-026-02372-0","relation":{},"ISSN":["1572-8595"],"issn-type":[{"value":"1572-8595","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"assertion":[{"value":"17 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"SH has received travel and education grants from Abbott and Johnson and Johnson RT has received honoraria for lectures from Pfizer, Abbott, Biosense Webster, Boston Scientific, Doctrina Med, cme4u, Medtronic, Radcliff Cardiology, and Wikonect. He has received honoraria for advisory board participation and consulting from Boston Scientific, Biosense Webster, Capvision, Guidepoint, Haemonetics, Medtronic, Philips, and Abbott. His institution has received research funding or participated in clinical trials sponsored by Biotronik, Abbott, Boston Scientific, Medtronic, Lifetech, and Johnson & Johnson. He has also received travel grants from Biosense Webster, Abbott, Boston Scientific, Medtronic, and Philips. JPW received funding of the German Foundation of Heart Research (F\/29\/19), speaker fees from Abbott and Doctrina Med, and travel grants from Boston Scientific in each case unrelated to this project. CE received travel grants and research grants from Abbott, Boston Scientific, Lifetech, Biosense Webster and Cardiofocus and speaker honoraria from Abbott, Boston Scientific, Biosense Webster, Cardiofocus and C.T.I. GmbH and Doctrina Med. SSP has received travel grants and congress grants from Lifetech and educational grants and a speaker grant from Abbott Medical. He is a medical consultant by Active Health. KHK reports grants and personal fees from Abbott Vascular, Medtronic, Biosense Webster outside the submitted work. VOLT CE Extended Study was funded by Abbott Open Access Fees will be covered by Abbott.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}