scholarly journals Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study (Preprint)

2020 ◽  
Author(s):  
Thomas Roxburgh ◽  
Anthony Li ◽  
Charles Guenancia ◽  
Patrice Pernollet ◽  
Claire Bouleti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Virtual Reality ◽  
Visual Analog Scale ◽  
Conscious Sedation ◽  
Small Sample ◽  
Control Group ◽  
Analog Scale ◽  
Af Ablation ◽  
Transcatheter Aortic Valve ◽  
Valve Implantation

BACKGROUND Connected devices are dramatically changing many aspects in health care. One such device, the virtual reality (VR) headset, has recently been shown to improve analgesia in a small sample of patients undergoing transcatheter aortic valve implantation. OBJECTIVE We aimed to investigate the feasibility and effectiveness of VR in patients undergoing atrial fibrillation (AF) ablation under conscious sedation. METHODS All patients who underwent an AF ablation with VR from March to May 2020 were included. Patients were compared to a consecutive cohort of patients who underwent AF ablation in the 3 months prior to the study. Primary efficacy was assessed by using a visual analog scale, summarizing the overall pain experienced during the ablation. RESULTS The AF cryoablation procedure with VR was performed for 48 patients (mean age 63.0, SD 10.9 years; n=16, 33.3% females). No patient refused to use the device, although 14.6% (n=7) terminated the VR session prematurely. Preparation of the VR headset took on average 78 (SD 13) seconds. Compared to the control group, the mean perceived pain, assessed with the visual analog scale, was lower in the VR group (3.5 [SD 1.5] vs 4.3 [SD 1.6]; <i>P</i>=.004), and comfort was higher in the VR group (7.5 [SD 1.6] vs 6.8 [SD 1.7]; <i>P</i>=.03). On the other hand, morphine consumption was not different between the groups. Lastly, complications, as well as procedure and fluoroscopy duration, were not different between the two groups. CONCLUSIONS We found that VR was associated with a reduction in the perception of pain in patients undergoing AF ablation under conscious sedation. Our findings demonstrate that VR can be easily incorporated into the standard ablation workflow.

scholarly journals Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study

10.2196/26349 ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. e26349
Author(s):  
Thomas Roxburgh ◽  
Anthony Li ◽  
Charles Guenancia ◽  
Patrice Pernollet ◽  
Claire Bouleti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Virtual Reality ◽  
Visual Analog Scale ◽  
Conscious Sedation ◽  
Small Sample ◽  
Control Group ◽  
Analog Scale ◽  
Af Ablation ◽  
Transcatheter Aortic Valve ◽  
Valve Implantation

Background Connected devices are dramatically changing many aspects in health care. One such device, the virtual reality (VR) headset, has recently been shown to improve analgesia in a small sample of patients undergoing transcatheter aortic valve implantation. Objective We aimed to investigate the feasibility and effectiveness of VR in patients undergoing atrial fibrillation (AF) ablation under conscious sedation. Methods All patients who underwent an AF ablation with VR from March to May 2020 were included. Patients were compared to a consecutive cohort of patients who underwent AF ablation in the 3 months prior to the study. Primary efficacy was assessed by using a visual analog scale, summarizing the overall pain experienced during the ablation. Results The AF cryoablation procedure with VR was performed for 48 patients (mean age 63.0, SD 10.9 years; n=16, 33.3% females). No patient refused to use the device, although 14.6% (n=7) terminated the VR session prematurely. Preparation of the VR headset took on average 78 (SD 13) seconds. Compared to the control group, the mean perceived pain, assessed with the visual analog scale, was lower in the VR group (3.5 [SD 1.5] vs 4.3 [SD 1.6]; P=.004), and comfort was higher in the VR group (7.5 [SD 1.6] vs 6.8 [SD 1.7]; P=.03). On the other hand, morphine consumption was not different between the groups. Lastly, complications, as well as procedure and fluoroscopy duration, were not different between the two groups. Conclusions We found that VR was associated with a reduction in the perception of pain in patients undergoing AF ablation under conscious sedation. Our findings demonstrate that VR can be easily incorporated into the standard ablation workflow.

scholarly journals Virtual reality to improve patient information and reduce anxiety towards atrial fibrillation ablation in times of remote patient care (and after)

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
ANL Hermans ◽  
P Van Duijnhoven ◽  
DVM Verhaert ◽  
S Philippens ◽  
M Lahaije ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Virtual Reality ◽  
Patient Care ◽  
Patient Information ◽  
Intervention Group ◽  
Control Group ◽  
Af Ablation ◽  
Significant Difference ◽  
Remote Patient ◽  
Preoperative Patient

Abstract Funding Acknowledgements Type of funding sources: None. Background. Nowadays frequently deployed invasive catheter ablation therapy in patients with symptomatic atrial fibrillation (AF) is unfortunately associated with distress such as preoperative anxiety. Improving preoperative patient information may lower anxiety towards AF ablation procedures. Purpose. To evaluate whether a lifelike 360˚ virtual reality (VR) patient information video decreases anxiety levels and improves patient preparation towards AF ablation as compared to standard preoperative patient information. Methods. Consecutive patients planned for AF ablation were recruited from the outpatient AF clinic and were randomized into two groups: the control group and the intervention group (VR group). The control group received standard preoperative information through oral counselling and information leaflets, the VR group received the standard information as well as a short dedicated 360˚ VR video (via in-hospital VR headset and disposable cardboard VR glasses for home use). Online questionnaires (aimed at information provision, anxiety and procedural experience) were administered both pre- and post-ablation. Results. A total of 103 patients (39.8% female, age 64 [58-71] years) were included in the analysis. The VR group (n = 58) reported to be clearly better informed about catheterization laboratory environment (78% vs. 73%) and the course of the procedure (82% vs. 78%), indicated fewer concerns about the procedure (47% vs. 55%) and were eager to learn even more (82% vs. 74%) as compared to controls (n = 45). However, there was no significant difference in the anxiety scores between the VR group and controls (10 [8-12] vs. 10 [8-14], p = 0.548). Home use of the video was satisfactory and resulted in discussion with relatives. Patient overall satisfaction was higher in VR group as compared to controls (84% vs. 81%). Conclusions. This study shows that a dedicated 360˚ VR video reduces concerns but does not reduce anxiety scores. Though, it easily improves procedural knowledge, patient information and patient satisfaction. Especially in times of remote patient care, this new way of informing patients may be of added value.

Virtual reality-assisted conscious sedation during transcatheter aortic valve implantation: a randomised pilot study

2020 ◽  
Vol 16 (12) ◽  
pp. e1014-e1020
Author(s):  
Raphael Romano Bruno ◽  
Yingfeng Lin ◽  
Georg Wolff ◽  
Amin Polzin ◽  
Verena Veulemans ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pilot Study ◽  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Conscious Sedation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

scholarly journals The effect of local ketamine infiltration on post tonsillectomy pain scale

2020 ◽  
Vol 50 (1) ◽  
pp. 38
Author(s):  
Ade Asyari ◽  
Novialdi Novialdi ◽  
Elniza Morina ◽  
Rimelda Aquinas ◽  
Nasman Puar ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Secondary Infection ◽  
Pain Scale ◽  
Control Group ◽  
Analog Scale ◽  
Noticeable Effect ◽  
Local Infiltration ◽  
Significant Difference ◽  
Post Test ◽  
Test Control

Background: Post tonsillectomy pain is one of the surgery side effects that most disturbing for patient’s comfort and will cause dysphagia, low intake, dehydration, secondary infection and bleeding. Ketamine is an anesthetic drug that has strong analgesic effect and easily available in any hospital at relatively cheap price. Objective: To find out the effect of local ketamine infiltration on the post tonsillectomy pain scale. Method: An experimental study during tonsillectomy with a Post Test Control Group on 12 samples without local infiltration of ketamine and 12 samples with local infiltration of ketamine in peritonsillar pillar. The pain was assessed 2 hours and 24 hours post extubation with pain Visual Analog Scale (VAS). Result: The VAS value from patients who were given local infiltration of ketamine in peritonsillar pillar were lower (5.83 ± 0.72 at 2 hours and 2.83 ± 0.58 at 24 hours post extubation) compared to patients without ketamine infiltration (7.83 ± 0.58 at 2 hours and 3.58 ± 0.51 at 24 hours post extubation). The result showed statistically significant difference (p <0.05) at 2 hours and 24 hours post extubation. Conclusion: The VAS score of the ketamine infiltration group is lower at 2 hours and 24 hours post extubation than the group without ketamine infiltration, showing there was a noticeable effect of local ketamine infiltration on the post tonsillectomy pain scale.Keywords : post tonsillectomy pain, ketamine, local infiltration, visual analog scale ABSTRAKLatar belakang: Nyeri pascatonsilektomi adalah salah satu efek samping operasi yang sangat mengganggu kenyamanan pasien, dan dapat menyebabkan gangguan menelan, kurangnya asupan nutrisi, dehidrasi, infeksi sekunder dan perdarahan. Ketamin merupakan obat anestesi yang memiliki efek analgetik yang kuat dan mudah didapatkan di semua tipe rumah sakit dengan harga yang relatif murah. Tujuan: Mengetahui efek pemberian infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi. Metode: Penelitian eksperimental dengan desain Post Test Control Group pada 12 sampel tanpa pemberian infiltrasi lokal ketamin dan 12 sampel dengan pemberian infiltrasi lokal ketamin di pilar peritonsil saat tonsilektomi. Dilakukan penilaian nyeri 2 jam dan 24 jam pascaekstubasi menggunakan skala nyeri Visual Analog Scale (VAS). Hasil: Nilai VAS pasien yang diberi infiltrasi lokal ketamin di pilar peritonsil lebih rendah (5,83±0,72 pada 2 jam dan 2,83 ± 0,58 pada 24 jam pascaekstubasi) dibanding tanpa diberi infiltrasi lokal ketamine (7,83 ± 0,58 pada 2 jam dan 3,58± 0,51 pada 24 jam pascaekstubasi), dan bermakna secara statistik (p<0,05) pada kedua penilaian. Kesimpulan: Terdapat efek nyata infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi, dimana nilai VAS kelompok yang diberi infiltrasi ketamin lebih rendah, baik pada 2 jam ataupun 24 jam pascaekstubasi dibanding kelompok yang tidak diberi infiltrasi ketamin.

scholarly journals Spinal cord stimulation for chronic intractable trunk or limb pain: study protocol for a Chinese multicenter randomized withdrawal trial (CITRIP study)

2020 ◽  
Author(s):  
Yang Lu ◽  
Peng Mao ◽  
Guihuai Wang ◽  
Wei Tao ◽  
Donglin Xiong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Visual Analog Scale ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Short Form ◽  
Control Group ◽  
Withdrawal Period ◽  
Analog Scale ◽  
Limb Pain ◽  
Vas Score

Abstract Background: Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain.Method：Participants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average Visual Analog Scale (VAS) score ≥ 5 will undergo spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-months follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre and post randomization) and 6 months. The primary outcome is the difference of maximal visual analog scale (VAS) score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1, 3 and 6-month follow-ups, responder rate (VAS score improving by 50%), achievement rate of a desirable pain state (VAS score ≤ 4), awake times during sleep, Beck Depression Inventory for depression evaluation, short-form 36 for quality of life evaluation, drug usage, satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle. Discussion：The CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.Trial registration: NCT03858790, clinicaltrials.gov, registered on March 1st, 2019, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03858790

scholarly journals PENGARUH INTRADYALITIC EXERCISE TERHADAP PENURUNAN NYERI PASIEN HEMODIALISA RUTIN DI UNIT HEMODIALISA RSUD Dr. TJITROWARDOJO PURWOREJO

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Wiwit Sugiarti ◽  
Sri Nabawiyati Nurul Makiyah ◽  
Azizah Khoiriyati
Keyword(s):  
Visual Analog Scale ◽  
Control Group ◽  
P Value ◽  
Analog Scale ◽  
Intradialytic Exercise

Latar belakang; Nyeri muskuloskeletal merupakan gejala yang dialami pasien gagal ginjal kronik yang menjalani hemodialisa.Manajemen nyeri dapat menggunakan distraksi relaksasi konvensional dan intradialytic exercise. Penelitian ini bertujuan untuk mengetahui efektivitas Intradialytic exercise dalam menurunkan nyeri pada pasien hemodialisa rutin di Unit Hemodialisa Rumah Sakit Umum Daerah Dr. Tjitrowardojo Purworejo.Metode; Rancangan penelitian yang digunakan eksperimen semu dengan desain pretest-posttest with control group. Respondennya 36 orang, terdiri dari 18 pasien yang diberi Intradialytic exercise sebagai kelompok intervensi dan 18 pasien lainnya hanya diberikan distraksi-relaksasi konvensional sebagai kelompok kontrol.  Pengukuran nyeri menggunakan Visual Analog Scale. Analisis datanya menggunakanPaired t Testdan  Independent Sample t Test.Hasil;  Hasil penelitian didapatkan perbedaan penurunan yang signifikan terhadap skor nyeri pre dan postes pada kelompok baik intervensi dan kelompok kontrol dengan p value 0,000 (p< 0,005 dan metode Intradialytic exercise lebih efektif dalam menurunkan skor nyeri dibandingkan metode distraksi-relaksasi konvensional pada pasien HD rutin  dengan p value 0,000 (p< 0,005). Kata kunci: Intradialytic Exercise, Nyeri

Abstract 16237: Zero Fluoroscopy Ablation of Atrial Fibrillation: A Safety and Feasibility Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Luigi Di Biase ◽  
Rodney Horton ◽  
Chintan Trivedi ◽  
Prasant Mohanty ◽  
Sanghamitra Mohanty ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Veins ◽  
Radiation Risk ◽  
Control Group ◽  
Short Term ◽  
Af Ablation ◽  
And Control ◽  
Zero Fluoroscopy

Introduction: Radiofrequency catheter ablation of atrial fibrillation is performed under fluoroscopic guidance and therefore carries radiation risk exposure for the both the patient and the operator. Three-dimensional mapping systems and newer technologies to allow non-fluoroscopic catheter visualization together with intracardiac echo have reduced but not abolished the fluoroscopy exposure. We aim to demonstrate the feasibility, the safety and the efficacy of catheter ablation for atrial fibrillation without the use of fluoroscopy. Methods: A totally fluoro-less approach was developed for AF ablation at our Institution. 94 consecutive AF patients underwent zero fluoroscopy catheter ablation for atrial fibrillation. In the zero fluoroscopy cases, the fluoroscopy arm was kept far away from the patient table. Access including double trans-septal, mapping with the Carto 3 system and ablation were all performed without fluoroscopy with the use of ICE and the Carto 3 system. These 94 patients were compared with 94 control patients matched for age, sex and type of AF who underwent AF ablation by the same operator with the use of fluoroscopy. Results: Baseline characteristics were similar between fluoroless (N=94, Age=64.5 ± 10.1, 75.5% male, 48% paroxysmal) and control (N=94, Age=65.1 ± 9.9, 72.3% male, 50% paroxysmal) group. Non-PV triggers were detected and ablated in 51 (54.3%) and 56 (59.6%) patients in fluoroless and control group respectively (p=0.5). Average fluoro time in control group was 10.1 ± 4.7 minutes. Procedure duration was comparable (120.4 ± 25.8 vs. 122.2 ± 28.7, p =0.6). After the short term median follow-up of 4.5 (4 – 6.5) months, 10 (10.6 %) patients in flourless and 9 (9.6%) patients in control group experienced recurrences (p=0.8).One pericardial effusion requiring pericardiocenteis occurred in the fluoroless group. Conclusions: Our series show that zero fluoroscopy ablation of atrial fibrillation with the use of newer technologies is feasible, safe and efficacious at the short term follow up. Importantly in our series the double transeptal was performed without fluoroscopy and the ablation was not limited to the pulmonary veins only but included ablation of the posterior wall, the coronary sinus and the left atrial appendage.

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