Impact of Virtual Reality on Anxiety and Pain During Implantation of Cardiac Implantable Electronic Devices (CIED)

Inclusion criteria * Age ≥ 18 years * Indication for implantation of a cardiac pacemaker, ICD, or CRT device due to one of the following: * Complete heart block (AV block III°) * Symptomatic bradycardia due to sinus node dysfunction * Tachy-brady syndrome * Atrial fibrillation with slow ventricular rate * Symptomatic bradycardia due to AV block II° type Mobitz * Secondary prevention of sudden cardiac death due to ventricular tachycardia * Primary prevention in patients with heart failure with reduced ejection fraction * Primary prevention in patients with heart failure with reduced ejection fraction and complete left bundle branch block * "Pace and ablate" strategy for therapy-resistant persistent atrial fibrillation * Need to Upgrade to CRT-P due to a high percentage of right ventricular pacing Exclusion Criteria: * Intolerance or inability to wear the VR headset * Significant language barrier preventing consent or cooperation * Need for deep sedation or general anesthesia for the procedure