Objective To develop and validate an evidence-based and predictive nursing model integrating with virtual reality (VR) technology, and explore its comprehensive effects on preoperative negative emotions, intraoperative stress responses, postoperative recovery quality and complications in atrial fibrillation (AF) patients treated with radiofrequency ablation under general anesthesia.

Methods A randomized controlled trial design was adopted. A total of 98 AF patients treated with radiofrequency ablation under general anesthesia were selected, and divided into the observation group (n = 49) and control group (n = 49) according to the random number table method. The control group received the standardized predictive nursing based on evidence-based theory. On this basis, two VR immersive relaxation experiences were introduced in the observation group before 1 day of operation and during the preoperative waiting period. The anxiety (SAS) and depression (SDS) scores, intraoperative hemodynamic index (HR, MAP) fluctuation values, anesthesia recovery period indicators (recovery time of spontaneous breathing, recovery time, RASS restlessness score), postoperative pain score (VAS), incidence of early postoperative complications and nursing satisfaction between two groups were compared before and after the intervention.

Results After the intervention, the SAS and SDS scores in the observation group were lower than those in control group, and the difference was statistically significant (P ＜ 0.01). During the operation, the fluctuation ranges of HR and MAP in the observation group at key time points such as anesthesia induction and start of operation were smaller than those in the control group, and the difference was statistically significant (P ＜ 0.01). The recovery time of spontaneous breathing and awakening time in the observation group were shorter than those in control group. The RASS restlessness score during the awakening period and VAS pain score after 6 hours of surgery in the observation group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05 to P ＜ 0.01). The total incidence of early postoperative complications in the observation group was 4.1%, significantly lower than 24.5% in the control group, the score of nursing satisfaction in the observation group was higher, and the difference was statistically significant (P ＜ 0.01).

Conclusions Integrating VR technology as a key intervention tool into the evidence-based and predictive nursing model can establish a systematic and humanized perioperative nursing protocol. It can not only more effectively relieve the psychological stress of patients, stabilize the physiological state during the operation, but also significantly improve the quality of anesthesia recovery, alleviate postoperative discomfort, and reduce the risk of complications. It is an effective strategy for optimizing the clinical nursing path of AF patients treated with radiofrequency ablation under general anesthesia.