Hypnotic communication for periprocedural analgesia during transcatheter ablation of atrial fibrillation

Abstract

Introduction Hypnosis is a therapeutic strategy for pain control. We aimed at investigating the use of this technique in a large population undergoing atrial fibrillation (AF) ablation. Methods 70 consecutive AF patients referred for transcatheter ablation, underwent hypnotic communication for periprocedural analgesia (Group A), were compared with 70 patients undergoing conventional analgesia (Group B). Procedural data, anxiety, perceived pain, perceived procedural duration and the dosages of administered analgesic drugs were compared using validated score scales. Results Hypnotic communication (Group A) resulted in a significant procedural-related anxiety reduction (Pre procedural 4.7 ± 2.9 Vs Intra Procedural 0.8 ± 1.2, P < 0.001) and perceived procedural duration (Real length 108 ± 33 min Vs Perceived Length 77 ± 39 min, P < 0.001). Group A patients reported a painless procedure in 78% (Pain scale ≤2). Regarding analgesic drug, Group A used only Fentanyl and Paracetamol. The Fentanyl dosage was similar in Group A and B (mean 0.142 Vs 0.146 mg, P = 0.65) while higher Paracetamol dosage was reported in Group A (mean 853 Vs 337 mg, P < 0.001). Group B also used Midazolam (mean 1.8 mg), Propofol (mean 43.8 mg) and narcosis was required in 2 patients. Total radiofrequency (RF) delivered time did not differ between the two groups (mean 28.9 Vs 27.6 min, P = 0.623) as well as mean RF power (mean 35.3 Vs 35.5 W, P = 0.424). No complications occurred. Conclusion Hypnotic communication during AF ablation was related to a significant reduction of intra-procedural anxiety, perceived pain, procedural analgesic drugs dosage and perceived procedural duration without affecting total RF delivered time and procedural safety.

Hypnotic communication during atrial fibrillation ablation: Another clinical application of hypnotherapy?

“…The present study by Scaglione et al is the first to describe the use of hypnotic communication in pain management during AF ablation [8]. The initial results suggest that adjuvant hypnotic communication is effective as periprocedural analgesic with a low risk for adverse events.…”

“…In conclusion, the work by Scaglione et al [8] nicely demonstrates the potential benefits of hypnotic communication to facilitate AF ablation. However, it remains unclear whether hypnotic communication can be taught to everyone and whether it is equally effective among different hospitals and caregivers.…”

“…In this issue of the International Journal of Cardiology Heart & Vasculatur, Scaglione et al describe a very interesting alternative to traditional general anesthesia and conscious sedation to facilitate AF ablation, namely hypnotic communication [8]. In an observational study consisting of 140 patients, the authors studied hypnotic communication as an adjuvant analgesic strategy to traditional conscious sedation.…”

“…In an observational study consisting of 140 patients, the authors studied hypnotic communication as an adjuvant analgesic strategy to traditional conscious sedation. They demonstrated that the use of adjuvant hypnotic communication was effective in three quarters of patients to achieve a pain free ablation and resulted in a reduced need for sedative drugs and a reduced need for non-invasive ventilatory support compared to traditional conscious sedation [8]. In addition, the use of hypnotic communication did not require additional personnel.…”

A Randomized Clinical Trial on the Effect of Hypnosis on Anxiety and Pain in Rigid Cystoscopy Patients

“…puncture, burn debridement or other burn care, surgical procedures, abortion, venipuncture, radiologic procedures, and angioplasty. [11][12][13][14][15][16][17][18] To our knowledge, this is the first report about the use of hypnosis for pain and anxiety management associated with rigid cystoscopy.…”