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| Author, year | Country | Journal | Target group | Type of VR application | Intervention group/control group | Sample size | Detail of groups (sex, age) | Session detail | Measured outcome | Outcome |
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| Jozwik et al., 2022 [24] | Poland | Healthcare | Patients with CHD | Psychological rehabilitation | CR + VR vs CR + schultz autogenic training | N = 34
VR+
CR = 11
CG = 23 | Sex: 34 M
Age
CG: 62.52 ± 7.18
EG: 66.55 ± 9.63 | 2 times a week for 4 weeks | (i) Anxiety level
(ii) Depression level
(iii) Emotional tension level
(iv) External stress level
(v) Intrapsychic stress level
(vi) Risk of lying | This study verified that VR leads to an improvement in the mental state of the patients |
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| Szczepanska-Gierachaet al., 2021 [25] | Poland | Cyberpsychology, behavior, and social networking | Patients with CAD | Psychological rehabilitation | CR + VR vs CR + schultz autogenic training | N = 32
VR+
CR = 15
CG = 17 | Sex
EG: 9 F, 6 M
CG: 11 F, 6 M
Age
CG: 68.41 ± 5.06
EG: 69.47 ± 7.54 | 2 times a week for 4 weeks | (i) Anxiety level
(ii) Depression level
(iii) Emotional tension level
(iv) External stress level
(v) Intrapsychic stress level
(vi) Risk of lying | This study confirmed that VR leads to an improvement in the mental state of the patients |
|
| Ribeiro et al., 2021 [26] | Brazil | Physiotherapy research international | Patients undergoing CABG | Physical rehabilitation | VR vs control group and EMG | N = 48
VR = 17
EMG = 15
CG = 16 | Sex
CG: 4 F, 11 M
EMG: 2 F, 13 M
VR: 7 F, 10 M
Age
CG: 60.3 ± 8.3
EMG: 58.3 ± 7.7
VR: 62.1 ± 9.0 | Not clear | (i) Heart rate variability
(ii) Time of discharge of hospital | Physiotherapy protocols, combined with VR training, improved a higher number of indicator indices and a shorter hospital stay after surgery |
|
| Patel et al., 2021 [27] | USA | The international journal of cardiovascular imaging | Medical students, residents, fellows, nurses, advanced practitioners, junior attending physicians, dieticians, and bioengineering PhD students | Anatomy education | VR vs a desktop computer interface | N = 51
VR = 24
CG = 27 | Sex
CG: 18 F, 9 M
VR: 16 F, 8 M
Age
CG: 30
VR: 28 | Not mentioned | (i) Visuospatial knowledge | There was no statistically significant difference between VR and the control group |
|
| Laghlam et al., 2021 [28] | France | Annals of intensive care | Patients undergoing cardiac surgery | Psychological rehabilitation | VR vs kalinox | N = 180
VR: 90
CG90 | Sex
CG: 18 F, 72 M
VR: 28 F, 62 M
Age
CG: 68
VR: 68 | 5 min before the removal of the drains, and was continued for 10 min after | (i) Pain level
(ii) Anxiety level | Although VR was well tolerated by patients and allowed a satisfying self-reported anxiety control, it failed to confirm noninferiority compared to Kalinox® for controlling pain and anxiety |
|
| Keshvari et al., 2021 [16] | Iran | Egyptian heart journal | Patients undergoing coronary angiography | Physical rehabilitation/psychological rehabilitation | VR vs usual care | N = 80
VR = 40
CG = 40 | Sex
CG: 15 F, 25 M
VR: 8 F, 32 M
Age
CG: 52.08 ± 4.002
VR: 50.95 ± 4.120 | 5 min for each patient | (i) Anxiety level
(ii) Heart rate
(iii) Respiratory rate
(iv) Blood pressure | VR distraction was effective in reducing anxiety before coronary artery angiography |
|
| Jozwik et al., 2021 [29] | Poland | Journal of clinical medicine | Patients with CAD | Psychological rehabilitation | CR + VR vs CR + schultz autogenic training | N = 77
VR = 28
CG = 49 | Sex
CG: 25 F, 24 M
VR: 17 F, 11 M
Age
CG: 63.96 ± 6.89
VR: 66.00 ± 9.73 | 8 sessions, 3 times a week | (i) Anxiety level
(ii) Depression level
(iii) General stress level
(iv) Emotional tension level
(v) External stress level
(vi) Intrapsychic stress level | The virtual environment with standard CR leads to a significant improvement in patients’ mental health |
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| Jozwik et al., 2021 [30] | Poland | Medicina | Patients with IHD | Psychological rehabilitation | CR + VR vs CR + schultz autogenic training | N = 43
VR+
CR = 17
CG = 26 | Sex
CG: 26 F
VR: 17 F
Age
CG: 65.23 ± 6.49
VR: 65.65 ± 10.07 | 3 times a week for 8 weeks | (i) Generalized stress level
(ii) Emotional tension level
(iii) External stress level
(iv) Intrapsychic stress level
(v) Depression level
(vi) Anxiety level | VR therapy is an efficient and interesting supplement to cardiac rehabilitation, with proven efficacy in reducing stress levels |
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| Gulick et al., 2021 [31] | USA | Journal of medical internet research | Patients undergoing cardiac rehabilitation | Physical rehabilitation/psychological rehabilitation | VR vs standard care | N = 35
VR = 16
CG = 19 | Age: 61 ± 9.9 | Not clear | (i) Knowledge retention
(ii) Patient satisfaction
(iii) Engagement | No improvements were seen in the VR group |
|
| da Cruz et al., 2021 [32] | Brazil | Physical therapy & rehabilitation journal | Patients with cardiovascular diseases or risk factors | Psychological rehabilitation | CR + VR vs traditional CR | N = 61
VR+
CR = 30
CG = 31 | Sex
CG: 7 F, 24 M
VR: 15 F, 15 M
Age
CG: 66.83 ± 10.93
VR: 63.27 ± 12.68 | 3 times a week for 12 weeks | (i) Adherence
(ii) Motivation
(iii) Engagement | Although VR increased program adherence but decreased patient motivation and absorption |
|
| Chang et al., 2021 [33] | Taiwan | Journal of the Chinese medical association | AF patients preparing for ablation | AF preprocedural education | VR vs paper-based materials | N = 33
VR = 11
CG = 22 | Sex
CG: 8 F, 14 M
VR: 9 F, 2 M
Age
CG: 30–40 (2), 40–50 (4), 50–60 (4), and >60 yrs (12)
VR: 30–40 (0), 40–50 (1), 50–60 (4), and >60 yrs (6) | Not clear | (i) Self-efficacy
(ii) Satisfaction | VR decreased periprocedural anxiety and smoothed the procedure of AF catheter ablation |
|
| Zinchenko et al., 2020 [34] | Russia | New ideas in psychology | Humanitarian students | Anatomy education | VR vs paper and 3D interactive model on a computer display | N = 45 | Sex
CG1: 9 M
CG2: 8 M
VR: 9 M
Age
CG1: 21.2 ± 2.3
CG2: 22.9 ± 3.5
VR: 22.7 ± 3.6 | 15 min | (i) Number of correct answers | VR was more efficient than reading texts or interacting with a 3D model on a computer screen |
|
| Katz et al., 2020 [35] | USA | Journal of medical internet research | Anesthesiology residents | ACLS training | VR vs high-fidelity simulation | N = 23
VR = 11
CG = 12 | Sex: 17 M, 8 F
Age: 25–35 | Not clear | (i) Technical skills
(ii) Behavioral skills
(iii) Cost | Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction |
|
| Hessabi, 2020 [36] | Iran | International journal of pharmaceutical and phytopharmacological research | Patients admitted to the CCUs | Psychological rehabilitation | VR vs usual care | N = 60
VR = 30
CG = 30 | Sex
CG: 15 M, 15 F
VR: 15 M, 15 F
Age
CG: 49.92 ± 7
VR: 52.03 ± 6 | On the second and third night of admission for 15 min | (i) Anxiety level | VR can effectively reduce anxiety in hospitalized patients in the CCU |
|
| García-Bravo et al., 2020 [37] | Spain | International journal of environmental research and public health | Patients with IHD | Physical rehabilitation/psychological rehabilitation | CR + VR vs traditional CR | N = 20
VR = 10
CG = 10 | Age
CG: 53.7 ± 10.30
EG: 48.70 ± 6.66 | 2 times a week for 8 weeks (60 min) | (i) Ergometry
(ii) Metabolic equivalents
(iii) Functional independence measure
(iv) 6MWT
(v) Aerobic capacity and endurance
(vi) Quality of life
(vii) Depression level
(viii) Satisfaction
(ix) Adherence | VR could be incorporated into CR programs |
|
| Alves da Cruz et al., 2020 [38] | Brazil | Archives of physical medicine and rehabilitation | Patients with cardiovascular diseases or risk factors | Physical rehabilitation | VR vs regular CR | N = 27 | Sex: 14 M, 13 F
Age: 63.40 ± 12.71 | Each VRBT or CR session lasted 85 minutes | (i) Heart rate
(ii) Blood pressure
(iii) Respiratory rate
(iv) Rating of perceived exertion
(v) peripheral oxygen saturation
(vi) Heart rate reserve
(vii) How long the patient maintained the prescribed
(viii) HRR | VR produces similar physiological acute hemodynamic effects in CR |
|
| Maresky et al., 2019 [39] | Canada | Clinical anatomy | Medical students | Anatomy education | VR vs independent study | N = 42
VR = 28
CG = 14 | Age: 18–34 | 30 min | (i) Number of correct answers | This study demonstrates the viability and the effectiveness of VR in teaching cardiac anatomy |
|
| Vieira et al., 2018 [40] | Portugal | Disability and rehabilitation: assistive technology | Patients with CAD | Physical rehabilitation/psychological rehabilitation | VR vs usual care and paper booklet | N = 33
VR = 11
EG2 = 11
CG = 11 | Sex: 33 M
Age
EG1: 55 ± 9.0
EG2: 59 ± 11.3
CG: 59 ± 5.8 | 3 times a week for 6 months | (i) Executive function
(ii) Ability to switch information
(iii) Working memory
(iv) Selective attention
(v) Conflict resolution ability
(vi) Quality of life
(vii) Depression level
(viii) Anxiety level
(ix) Stress level | The VR improved attention and conflict resolution ability, revealing the potential of CR, specifically with virtual reality exercise, on executive function |
|
| Vieira, 2017 [41] | Portugal | European journal of integrative medicine | Patients with CAD | Physical rehabilitation | VR vs usual care and paper booklet | N = 33
EG2 = 11
CG = 11 | Sex: 33 M
Age
EG1: 55 ± 9.0
EG2: 59 ± 11.3
CG: 59 ± 5.8 | 3 times a week for 6 months | (i) Total cholesterol levels
(ii) High-density lipoprotein
(iii) Low-density lipoprotein
(iv) Triglycerides
(v) Lean mass
(vi) Body mass index
(vii) Body fat at the trunk
(viii) Total body fat
(ix) Waist-to-height ratio | VR had a positive effect on body composition |
|
| Voelker et al., 2016 [42] | Germany | Journal of interventional cardiology | Cardiology fellows | Cardiac catheterization training | VR vs lectures | N = 18
VR = 9
CG = 9 | Not mentioned | 7.5 hours | (i) Participant’s performance quality
(ii) Procedure time
(iii) Fluoroscopy time | VR simulation training improved the performance level of cardiology fellows |
|
| Valdis et al., 2015 [43] | Canada | Innovations-technology and techniques in cardiothoracic and vascular surgery | Surgical trainees | Robotic cardiac surgery training | VR vs no training | N = 19
VR = 9
CG = 10 | Sex
CG: 6 M, 4 F
VR: 8 M, 2 F
Age
CG: 29.9 ± 2.4
VR: 32.7 ± 6.1 | The average duration of VR: 9.3 hours | (i) Standardized robotic internal thoracic artery harvest
(ii) Mitral valve annuloplasty | VR can significantly improve the efficiency and quality of learning in robotic cardiac surgery |
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| Khanal et al., 2014 [44] | USA | Journal of biomedical informatics | Care providers | ACLS training | VR vs traditional ACLS training | N = 148 | Sex: 10 M, 138 F | 30 minutes | (i) Time for each task | VR-based ACLS training can provide a learning experience similar to face-to-face training |
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| Cacau et al., 2013 [45] | Brazil | Revista brasileira de cirurgia cardiovascular | Patients in the postoperative period | Physical rehabilitation/psychological rehabilitation | VR vs conventional physical therapy | N = 60
VR = 30
CG = 30 | Sex
CG: 16 M, 14 F
VR: 13 M, 17 F
Age
CG: 52 ± 2.4
VR: 49.2 ± 2.6 | Twice a day | (i) Functional performance
(ii) 6MWT
(iii) Length of hospitalization
(iv) Functional independence measure
(v) Quality of life | Adjunctive treatment with VR demonstrated better functional performance in patients |
|
| Bagai et al., 2012 [46] | Canada | Circulation-cardiovascular interventions | Cardiology trainees | Cardiac catheterization training | VR vs apprenticeship-based training | N = 27
VR = 11
CG = 15 | Sex
CG: 13 M, 2 F
VR: 5 M, 6 F
Age
CG: 31
VR: 29 | Not mentioned | (i) Mounting the catheter on the guidewire
(ii) Cannulating the coronary arteries exchanging catheters
(iii) Obtaining and interpreting standard angiographic views
(iv) Overall assessment of wire catheter skills
(v) Time, efficiency, and ability to complete the case
(vi) Need for verbal prompts
(vii) Attending take over | Skills required to perform cardiac catheterization can be learned via mentored simulation training |
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| Chuang et al., 2006 [47] | Taiwan | Physical therapy | Patients undergoing CABG | Physical rehabilitation | VR vs usual rehabilitation | N = 20
VR = 10
CG = 10 | Sex: 20 M
Age
CG: 63.70 ± 10.03
VR: 65.70 ± 14.48 | 2 times a week for about 3 months (30 min) | (i) Heart rate
(ii) VO2max
(iii) Treadmill grades and speeds
(iv) Blood pressure | This study showed a powerful effect of VR on the progress of cardiac rehabilitation |
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| Chuang et al., 2005 [48] | Taiwan | Archives of physical medicine and rehabilitation | Patients undergoing CABG | Physical rehabilitation | VR vs usual rehabilitation | N = 32
VR = 17
CG = 15 | Sex
CG: 13 M, 2 F
VR: 15 M, 2 F
Age
CG: 68.67 ± 12.32
VR: 64.41 ± 7.66 | 2 times a week for about 3 months (30 min) | (i) Heart rate
(ii) Blood pressure
(iii) Rating of perceived exertion
(iv) VO2max | Treadmill training enhanced by VR was superior to conventional exercise protocols for post-CABG patients |
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