Aims: Virtual reality hypnosis (VRH) has been used successfully in various clinical settings to decrease anxiety and the sensation of pain. We aimed to investigate the feasibility and safety of VRH in patients undergoing electrophysiology and pacing procedures under conscious sedation. Methods: During a two-month period, VRH support was proposed and accepted by 25 patients undergoing electrophysiological procedures. Data were compared with a control group (n = 61) enrolled during the following three-month period. Both groups underwent the measurement of the duration of intervention, the consumption of analgesics and hypnotics, and their pain and comfort using a validated visual analogue scale (VAS 0−10). Results: The baseline characteristics were comparable in both groups, including age. There were no differences in procedure duration (46 (±29) vs. 56 (±32) min, p = 0.18) or in hypnotic/antalgic consumption (midazolam 1.95 (±1.44) vs. 2.00 (±1.22) mg, p = 0.83; sufentanyl 3.78 (±2.87) vs. 3.58 (±2.48) μg, p = 0.9) between the control and VRH groups. In a multivariate analysis, the use of VRH was independently associated with lower comfort during the procedure assessed by postoperative visual analogue scale (OR 15.00 [95% CI 4.77−47.16], p < 0.01). There was no influence of VRH use on pain or drug consumption. Conclusions: In our experience, compared with VRH, human care is preferable during procedures in electrophysiology lab to improve the comfort of the patient. VRH has no influence on pain or drug consumption.
The wearable cardioverter defibrillator (WCD) has been proven to be effective in preventing sudden cardiac death (SCD) in patients soon after acute myocardial infarction (AMI) and left ventricular ejection fraction (LVEF) ≤35%. The aim of this study was to assess whether a WCD may shorten the length of an initial hospital stay (total length, days in the intensive care unit (ICU) and in the acute cardiac care unit (ACCU)) among these patients. This was a single-centre, retrospective observational study of patients referred for the management of SCD risk post-AMI and LVEF ≤35%, in a tertiary care hospital. The clinical characteristics and length of index hospitalization of the group of patients discharged, with or without WCD, were compared. A propensity score analysis was performed, then weighted regression models were conducted. A total of 101 patients in the WCD group and 29 in the control group were enrolled in the analysis. In the weighted regression models, WCD significantly reduced the days spent in ACCU (p < 0.001). WCD patients had significantly fewer days spent in ACCU (5.5 ± 2.6 vs. 8.4 ± 12.8 days, p < 0.001) and shorter hospitalizations (10.2 ± 5.7 vs. 13.4 ± 17.6 days, p = 0.005), compared with the control group. It was concluded that the WCD appears to reduce the total length of hospitalization and lengths of stay in ACCU for patients post-AMI and with left ventricular dysfunction.
UNSTRUCTURED Aims: Virtual reality Hypnosis (VRH) has been used successfully in different clinical settings to treat anxiety and the sensation of pain. We aimed to investigate the feasibility and safety of VRH in patients undergoing electrophysiology and stimulation procedures under conscious sedation. Methods: During a two-month period, VRH support was proposed to patients undergoing interventions. Data were compared with a control group (n=61) enrolled during the following three-month period. In the intervention group (n=25), the dedicated VR hypnosis programme was projected during the procedure. In both groups, pain and comfort were measured at the end of the procedure and at discharge, using visual analogue scales (VASs; 0-10). Results: Baseline characteristics were comparable in both groups. There was no difference in procedure duration (46 (±29) vs 56 (±32) min, p=0,18) nor in hypnotic / antalgic consumption (1.95 (±1.44) vs 2.00 (±1.22) mg, p=0,83 and 3.78 (±2.87) vs 3.58 (±2.48) μg, p=0,9) for the control and VR groups respectively. In a multivariate analysis, the use of VR was independently associated with lower comfort during the procedure, assessed by post-operative VAS (OR 15.00 (IC95%4.77;47.16), p<0.01). There was no influence of VR use on pain or drug consumption. Conclusions: In our experience, VR hypnosis in the EP lab doesn’t improve comfort during the procedure, compared to conventional human care. It has no influence on pain or drug consumption.
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