The goal is simple. Going to “destroy” that handful of cells that somehow become the engine for the development of atrial fibrillation, the most common arrhythmia. In some cases, in fact, in selected patients it may become necessary to proceed with this approach, which can be based both on heat, with what is called thermal ablation, both on very low temperatures that aim at the same end, that is with the cryoablation. The intervention is carried out by the specialist who brings this source of very low temperature exactly in the vicinity of the area of cells to be “canceled” in their function. In the event that the specialist proceeds with the treatment in conscious sedation, obviously, some discomfort may be present in the subject to be treated. And above all, after the therapy, pain can persist.
The headphone that reduces pain
According to research that appeared on Journal of Medical Internet Research, and coordinated by Thomas Roxburgh, however, there is a countermeasure to limit these problems: it is called virtual reality and aims to “transport” the subject being treated for fibrillation in a more peaceful situation, through specific programs that “act” on the patient. The study examined 48 patients undergoing atrial fibrillation cryoablation, who wore a virtual reality headset during the surgery, comparing its effects with what was observed in about fifty people who instead had traditional treatment with analgesics. . The results are certainly interesting: in the group subjected to virtual reality the average perceived pain was lower than in the controls, with a better endurance of the procedure. However, it must be said that virtual reality in about 15% of patients led to the suspension of the session in progress, due to the appearance of loss of consciousness and signs related to “cybersickness“. This condition, similar to seasickness, can occur in the form of nausea and dizziness and appears linked to the use of viewers for virtual reality, even if obviously motion sickness does not occur in the presence of real physical movement.
Atrial fibrillation, a chip under the skin reveals the invisible arrhythmia
at Federico Mereta
While waiting for further studies to shed light on the possibility of using these strategies to put the patient at ease during treatment, the certainty remains that the technique is becoming increasingly important in the treatment of specific forms of atrial fibrillation. “Cryoablation of atrial fibrillation is a procedure that allows you to electrically isolate the pulmonary veins of the left atrium through the use of low temperatures – explains Alessandro Costa, specialist at the Cardiology Division of the Irccs Sacro Cuore-Don Calabria Hospital in Negrar. In this way the problem is treated at the origin since, contrary to popular belief, it does not reside in the atrium but depends on the pulmonary veins “. For some years, the definitive treatment for this type of arrhythmia involves electrically and circumferentially disconnecting the pulmonary veins of the left atrium using different forms of energy, such as radiofrequency, cold or laser. “The cryoablation of atrial fibrillation is a method that is spreading rapidly: it can also be performed in an alert patient, it is generally well tolerated even if carried out under local anesthesia – Costa continues. It is common experience, however (also supported by clinical studies), that In this way patients feel an annoying headache, during the freezing phases, and not rarely a modest thoracic discomfort. Often, the forced supine position determines an annoying back pain. For all this, at our Center we perform the cryo-ablation of the atrial fibrillation under general anesthesia, in collaboration with the anesthesiologists. In the awakening phase, it is possible to feel a certain sore throat – due to intubation – and a little nausea, due to anesthetic drugs. The modest chest pain, generally found in the post-operative period, it is due to the inflammatory effect caused by low temperatures on the heart tissue and the entire organs smo. These discomforts, generally mild, are easily solved by intravenous administration of simple paracetamol “.
Heart door
Atrial fibrillation, an “oversized” waistline signals risk
at Federico Mereta
.