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Tigges-Limmer K, Brocks Y, Winkler Y, Stock Gissendanner S, Gummert J. Clinical experience with medical hypnosis as an adjunctive therapy in heart surgery. Front Psychol 2024; 15:1356392. [PMID: 38440236 PMCID: PMC10910116 DOI: 10.3389/fpsyg.2024.1356392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Heart surgery patients are at high risk for psychological trauma and comorbid psychological disorders. Depression, anxiety, and post-traumatic stress disorders in this patient group are predictors of outcomes after cardiac surgery. Medical hypnosis is effective for non-pharmacologic prevention and treatment of psychological disorders and has been associated with improved health-related quality of life and better cardiovascular outcomes. This contribution makes note of evidence of the effectiveness of medical hypnosis in a discussion of the clinical experience with specific hypnotherapeutic tools and interventions from the perspective of the mental health team in one large cardiac center in Germany. Based on our experience, we encourage heart centers to educate their heart surgery care teams about the core concepts of medical hypnosis and to make hypnotherapeutic techniques available as an adjunctive therapy.
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Affiliation(s)
- Katharina Tigges-Limmer
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | - Yvonne Brocks
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | - Yvonne Winkler
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | | | - Jan Gummert
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
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Berner A, Tobler C, Reinmann-Assouline M, Degrauwe S, Coen M. Arrhythmia conversion to sinus rhythm during a hypnosis: Is hypnosis a normal bystander or a guilty accomplice? INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VASCULATURE 2022; 38:100930. [PMID: 35024427 PMCID: PMC8724937 DOI: 10.1016/j.ijcha.2021.100930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/25/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Amandine Berner
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Caroline Tobler
- Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
| | | | - Sophie Degrauwe
- Cardiology Division, Geneva University Hospitals, Geneva, Switzerland
| | - Matteo Coen
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland.,Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Vanreusel I, Maes S, De Wolf D, Van Berendoncks A. Percutaneous closure of a secundum atrial septum defect performed under hypnosis: a case report. Acta Cardiol 2021; 76:1078-1082. [PMID: 32964783 DOI: 10.1080/00015385.2020.1822491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Atrial septal defects (ASDs) are the third most common type of congenital heart diseases with ostium secundum defects (ASDsII) being responsible for approximately 75% of these defects. The treatment consists of either a transcatheter closure or a surgical intervention. The transcatheter approach offers a less invasive alternative for patients who fulfill anatomical and size criteria and is therefore increasingly used as the preferred primary intervention. As general anaesthesia is sometimes contra-indicated for some patients needing ASD or PFO closure and intracardiac echocardiography (ICE) is not always readily available, alternative "supportive" techniques as hypnosis could be of interest. In our case, a relative contra-indication for general anaesthesia was pronounced due to the severely impaired pulmonary function caused by severe deformative torsional scoliosis. Over the years several reviews have been published on hypnotic analgesia used together with usual care suggesting that hypnotic analgesia is a promising non-pharmacologic adjunct treatment for ameliorating pain and surgical distress. Also, various cardiological procedures under hypnosis have already been described in literature, but this is the first time that percutaneous ASD closure under virtual reality (VR) hypnosis is mentioned in literature.
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Affiliation(s)
| | - S. Maes
- Department of Anesthesiology, University Hospital of Antwerp, Edegem, Belgium
| | - D. De Wolf
- Department of Pediatric Cardiology, University Hospital of Ghent, Ghent, Belgium
| | - A. Van Berendoncks
- University of Antwerp, Antwerp, Belgium
- Department of Cardiology, University Hospital of Antwerp, Edegem, Belgium
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Scaglione M, Battaglia A, Lamanna A, Cerrato N, Di Donna P, Bertagnin E, Muro M, Alberto Caruzzo C, Gagliardi M, Caponi D. Adjunctive hypnotic communication for analgosedation in subcutaneous implantable cardioverter defibrillator implantation. A prospective single center pilot study. IJC HEART & VASCULATURE 2021; 35:100839. [PMID: 34307829 PMCID: PMC8287220 DOI: 10.1016/j.ijcha.2021.100839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 11/04/2022]
Abstract
Background Subcutaneous implantable cardioverter defibrillator (S-ICD) is a well-established therapy for sudden death prevention. Considering the painful nature of the procedure anaesthesia may be required for analgo-sedation. Hypnosis is emerging as a promising therapeutic strategy for pain control. Few data are available regarding the use of hypnosis as adjunctive technique for pain control during S-ICD implantation. Methods Thirty consecutive patients referred to our centre for S-ICD implantation were prospectively and alternatively allocated with 1:1 ratio in two groups: A) Standard analgo-sedation approach (Hypnosis non responder patients) B) Standard analgo-sedation approach with the addition of hypnotic communication (Hypnosis responder patients). Peri-procedural pain perception and anxiety, perceived procedural length, type and dosage of administered analgesic drugs have been measured using validate scores and compared. Results Hypnotic communication was offered to 15 patients of which was successful in 11 patients (73%). There were no statistical differences between the two study groups according to baseline characteristics. Hypnosis communication resulted in significant pain perception reduction (Group A 6,9 ± 1,6 Vs Group B 1,1 ± 0,9, p value < 0,01), peri-procedural anxiety (Group A 3,5 ± 1,6 Vs Group B 1,9 ± 0,5, p value < 0,01) and reduced perceived procedural length (Group A 58,7 ± 13,4 min Vs Group B 44,7 ± 5,5 min, p value < 0,01). Fentanyl dosage was significantly lower in Group B patients. Conclusions Our results demonstrated a significant reduction of perceived pain, anxiety, procedural time and use of analgesic drugs in hypnosis responder patients. These results reinforce the beneficial effects of the hypnotic technique in patients undergoing S-ICD implantation.
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Affiliation(s)
- Marco Scaglione
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | | | - Andrea Lamanna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Natascia Cerrato
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Paolo Di Donna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Enrico Bertagnin
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Milena Muro
- Pain Therapy and Palliative Care, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
| | | | - Marco Gagliardi
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Domenico Caponi
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
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Lerche M, Sepehri Shamloo A, Hindricks G. [Current applications of hypnosis in the field of cardiac electrophysiology]. Herz 2021; 46:336-341. [PMID: 34309699 DOI: 10.1007/s00059-021-05048-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
With a growing acceptance of clinical hypnosis in medicine, new fields of application are being explored. Data from recent studies support the use of hypnosis for pain management during procedures, such as ablation of arrhythmias and implantation of subcutaneous implantable cardioverter defibrillators, management of preoperative anxiety and reduction of postoperative atrial fibrillation. The aim of this review article is to summarize the findings of investigations showing the application of hypnosis in the field of cardiac electrophysiology, to review the rationale for the efficacy of hypnosis in management of cardiac arrhythmias and to highlight possible future directions in clinical applications and scientific perspectives.
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Affiliation(s)
- Matthias Lerche
- Abteilung für Elektrophysiologie, Herzzentrum Leipzig - Universitätsklinik, Strümpellstraße 39, 04289, Leipzig, Deutschland.
- Department of Electrophysiology, Heart Center Leizpig at Universty of Leipzig, Leipzig, Germany.
| | - Alireza Sepehri Shamloo
- Abteilung für Elektrophysiologie, Herzzentrum Leipzig - Universitätsklinik, Strümpellstraße 39, 04289, Leipzig, Deutschland
- Department of Electrophysiology, Heart Center Leizpig at Universty of Leipzig, Leipzig, Germany
| | - Gerhard Hindricks
- Abteilung für Elektrophysiologie, Herzzentrum Leipzig - Universitätsklinik, Strümpellstraße 39, 04289, Leipzig, Deutschland
- Department of Electrophysiology, Heart Center Leizpig at Universty of Leipzig, Leipzig, Germany
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Roxburgh T, Li A, Guenancia C, Pernollet P, Bouleti C, Alos B, Gras M, Kerforne T, Frasca D, Le Gal F, Christiaens L, Degand B, Garcia R. Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study. J Med Internet Res 2021; 23:e26349. [PMID: 34042589 PMCID: PMC8193475 DOI: 10.2196/26349] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/23/2021] [Accepted: 05/04/2021] [Indexed: 01/02/2023] Open
Abstract
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.
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Affiliation(s)
- Thomas Roxburgh
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Anthony Li
- Cardiology Clinical Academic Group, St George's, University of London, London, United Kingdom
| | | | - Patrice Pernollet
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Claire Bouleti
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Benjamin Alos
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Matthieu Gras
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Thomas Kerforne
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Denis Frasca
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - François Le Gal
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Luc Christiaens
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Bruno Degand
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
| | - Rodrigue Garcia
- Department of Anesthesia and Critical Care, University Hospital of Poitiers, Poitiers, France
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Tezcan B, Ademoğlu D, Can M, Kazancı D, Mungan İ, Taştemur S, Ceylan C, Turan S. A Randomized Clinical Trial on the Effect of Hypnosis on Anxiety and Pain in Rigid Cystoscopy Patients. J Endourol 2020; 35:47-53. [PMID: 32867544 DOI: 10.1089/end.2020.0101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Cystoscopy is one of the most common procedures in outpatient urology. Although flexible cystoscopes are more tolerable, rigid cystoscopes have still been used in many clinics because of their lower costs, better visual performance, and easier handling. It can be difficult to achieve optimal relief of pain and anxiety during rigid cystoscopy. The aim of the present prospective randomized study was to evaluate the efficacy of hypnosis as an adjunct to routine local anesthesia in reducing pain and anxiety in rigid cystoscopy patients. Materials and Methods: Ninety male patients undergoing rigid cystoscopy for the first time were randomized into two groups: (1) Hypnosis Group (Group H) patients underwent cystoscopy with hypnotic communication as an adjuvant approach for periprocedural analgesia and anxiety, (2) Standard Care Group (Group SC) patients underwent cystoscopy with routine local anesthesia and lubrication as control group. The data were collected using visual analog scale (VAS) for pain, State-Trait Anxiety Inventory (STAI) for anxiety and hemodynamic parameters. Furthermore, a VAS was also completed by the urologist to assess his satisfaction. Results: Baseline characteristics, STAI, hemodynamic parameters, and recovery duration were statistically similar between the two groups. The procedure duration was shorter in Group H (p = 0.018). The postprocedural STAI and VAS scores of patients in Group H were significantly lower than those of Group SC (p = 0.006; p = 0.02, respectively). Heart rate and mean arterial pressure after positioning of the patient (p = 0.000; p = 0.004, respectively) and insertion of the cystoscope (p = 0.000; p = 0.000) were statistically lower in Group H, whereas baseline, postprocedural, and predischarge hemodynamic measurements were similar. Urologists were also more satisfied in Group H (p = 0.000). Conclusion: Hypnosis as an adjunct therapy to local anesthesia during rigid cystoscopy significantly reduces pain and anxiety, provides more stable hemodynamic conditions, shortens procedure duration, and thus appears attractive for pain and anxiety management.
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Affiliation(s)
- Büşra Tezcan
- Intensive Care Clinic, Ankara City Hospital, Ankara, Turkey
| | - Derya Ademoğlu
- Intensive Care Clinic, İstanbul Başakşehir City Hospital, İstanbul, Turkey
| | - Müçteba Can
- Intensive Care Clinic, Ankara City Hospital, Ankara, Turkey
| | - Dilek Kazancı
- Intensive Care Clinic, Ankara City Hospital, Ankara, Turkey
| | - İbrahim Mungan
- Intensive Care Clinic, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Sedat Taştemur
- Department of Urology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Cavit Ceylan
- Department of Urology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Sema Turan
- Intensive Care Clinic, Ankara City Hospital, Ankara, Turkey
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Scaglione M, Peyracchia M, Battaglia A, Di Donna P, Cerrato N, Lamanna A, Caponi D. Subcutaneous implantable cardioverter-defibrillator implantation assisted by hypnotic communication in a patient with Brugada syndrome. HeartRhythm Case Rep 2019; 6:198-201. [PMID: 32322496 PMCID: PMC7156977 DOI: 10.1016/j.hrcr.2019.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Marco Scaglione
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | | | | | - Paolo Di Donna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Natascia Cerrato
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Andrea Lamanna
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
| | - Domenico Caponi
- Division of Cardiology, Cardinal G. Massaia Hospital, Asti, Italy
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Hypnotic communication during atrial fibrillation ablation: Another clinical application of hypnotherapy? IJC HEART & VASCULATURE 2019; 24:100408. [PMID: 31453313 PMCID: PMC6700424 DOI: 10.1016/j.ijcha.2019.100408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/03/2019] [Indexed: 01/05/2023]
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