Visualization and attentive behavior for pain reduction during radiofrequency ablation of atrial fibrillation.

Background: Radiofrequency (RF) ablation of atrial fibrillation (AF) can be accompanied by pain and anxiety when light conscious sedation is used. We sought to determine how visualization and structured attentive behavior during ablation of AF could reduce pain intensity, spontaneously expressed pain, the amount of analgesics, anxiety, and adverse events.

Methods: A clinical controlled study with 71 patients in a control group (CG), receiving conventional care and treatment, and 76 patients in an intervention group (IG), receiving relaxation and visualization, combined with a structured attentive behavior from staff.

Results: There was no difference between CG and IG in perception of pain intensity at 15-minute intervals; mean pain intensity: CG (0.00-2.90), IG (0.12-2.57), (NS), but patients spontaneously expressed pain less numbers of time outside fixed intervals in the IG: 1.4 ± 1.2 times (mean ± standard deviation [SD]) compared to CG: 2.8 ± 1.8 (P < 0.01). There was a statistically significant difference between the amount of analgesics (Fentanyl) used in the two groups: CG: 292.3 ± 107 μg (mean ± SD) and IG: 220.7 ± 93 μg (P < 0.0001). No effect was observed in perception of anxiety, mean anxiety: CG (0.10-1.84), IG (0.9-2.03)(NS), and the number of adverse events (P = 0.241).

Conclusion: Visualization and structured attentive behavior was shown to reduce the amount of analgesics during the RF ablation of AF. There was no difference in perception of pain intensity, but the patients spontaneously expressed pain significantly less numbers of times outside the scheduled measurements. There was no reduction in anxiety and numbers of adverse events.