Supraventricular tachycardia and catheter ablation: Anxiety levels and patient perceptions

Authors

  • Ahmed Yasser Mohamed El-Medany University of Edinburgh
  • Neil Robert Grubb Department of Cardiology, Royal Infirmary of Edinburgh, UK HSL, University of Edinburgh

DOI:

https://doi.org/10.2218/resmedica.v22i1.817

Keywords:

Supraventricular tachycardia, anxiety, patient perception, catheter ablation

Abstract

Aim: To investigate anxiety levels and patient perception associated with supraventricular tachycardia (SVT); investigate anxiety levels and patient perception pre- and post- radiofrequency catheter ablation (RFCA); and explore any association between anxiety and patient perception with patient age and gender.

Design: Follow-up quantitative and qualitative cohort study. 141 patients in a tertiary centre in Scotland who underwent an electrophysiological study and RFCA for atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia or atrial tachycardia between 2009 and 2012 were enrolled. 59 (41.8%) were male; mean age at follow-up was 50 years.

Interventions: Follow-up by structured phone questionnaire; mean follow-up period was 14 months.

Main outcome measures: Anxiety level and patient perception during index episode, and anxiety level before and after RFCA.

Results: During index episode, median patient anxiety, on a scale of 0–10, was 8. Anxiety was not associated with gender (p = 0.07). Patients in the lowest and highest anxiety groups tended to be older (mean 54.5 and 44.4 years respectively) compared with those in the middle 2 groups (mean 34.1 and 35.6 years). There was an association between anxiety and age (p = 0.039). 45 (32.0%) participants thought they were having a heart attack or dying. Before RFCA, median anxiety level was 7. 55 (39.0%) patients were afraid of complications, 21 (14.9%) patients feared being awake during RFCA. After RFCA, median anxiety was 2.5.

Conclusions: Anxiety is a common accompaniment to SVT that may lead to greater pre-procedural anxiety. Exploring this link may allow reduction of anxiety via better psychopharmacological intervention, education, and preprocedural counselling.

Author Biographies

Ahmed Yasser Mohamed El-Medany, University of Edinburgh

MBChB Year 5 student

Neil Robert Grubb, Department of Cardiology, Royal Infirmary of Edinburgh, UK HSL, University of Edinburgh

Consultant Cardiologist, Cardiology department, Royal infrimary of Edinburgh

 

Senior lecturer, University of Edinburgh 

References

Baine, W. B., Yu, W., & Weis, K. A. Trends and outcomes in the hospitalization of older Americans for cardiac conduction disorders or arrhythmias, 1991–1998. Journal of the American Geriatrics Society, 2001;49(6), 763-770. http://www.ncbi.nlm.nih.gov/pubmed/11454115

Orejarena, L. A., Vidaillet, H., DeStefano, F., Nordstrom, D. L., Vierkant, R. A., Smith, P. N., & Hayes, J. J. Paroxysmal supraventricular tachycardia in the general population. Journal of the American College of Cardiology, 1998;31(1), 150-157. http://content.onlinejacc.org/article.aspx?articleid=1124326

Akhtar M, Jazayeri MR, Sra J, Blanck Z, Deshpande S, Dhala A. Atrioventricular nodal reentry. Clinical, electrophysiological, and therapeutic considerations. Circulation. Jul 1993;88(1):282-95. http://www.ncbi.nlm.nih.gov/pubmed/8319342

Josephson ME, Kastor JA. Supraventricular tachycardia: mechanisms and management. Ann Intern Med. Sep 1977;87(3):346-58. http://www.ncbi.nlm.nih.gov/pubmed/332025

Jazayeri MR, Hempe SL, Sra JS, et al. Selective transcatheter ablation of the fast and slow pathways using radiofrequency energy in patients with atrioventricular nodal reentrant tachycardia. Circulation. Apr 1992;85(4):1318-28. http://www.ncbi.nlm.nih.gov/pubmed/1555276

Brugada P, Wellens HJ. The role of triggered activity in clinical ventricular arrhythmias. Pacing Clin Electrophysiol. Mar 1984;7(2):260-71. http://www.ncbi.nlm.nih.gov/pubmed/6200854

Lesh MD, Van Hare GF, Epstein LM, et al. Radiofrequency catheter ablation of atrial arrhythmias. Results and mechanisms. Circulation. Mar 1994;89(3):1074-89. http://www.ncbi.nlm.nih.gov/pubmed/8124793

Ma G, Brady WJ, Pollack M, Chan TC. Electrocardiographic manifestations: digitalis toxicity. J Emerg Med. Feb 2001;20(2):145-52. http://www.ncbi.nlm.nih.gov/pubmed/11207409

Al-Khatib SM, Pritchett EL. Clinical features of Wolff-Parkinson-White syndrome. Am Heart J. Sep 1999;138(3 Pt 1):403-13 http://www.ncbi.nlm.nih.gov/pubmed/10467188

Wood KA, Drew BJ, Scheinman MM. Frequency of disabling symptoms in supraventricular tachycardia.Am J Cardiol. Jan 15 1997;79(2):145-9. http://www.ncbi.nlm.nih.gov/pubmed/9193013

Lessmeier, T. J., Gamperling, D., Johnson-Liddon, V., Fromm, B. S., Steinman, R. T., Meissner, M. D., & Lehmann, M. H. Unrecognized paroxysmal supraventricular tachycardia: potential for misdiagnosis as panic disorder.Arch Intern Med, 1997; 157(5), 537. http://www.ncbi.nlm.nih.gov/pubmed/9066458

McCrank E, Schurmans K, Lefcoe D. Paroxysmal supraventricular tachycardia misdiagnosed as panic disorder. Arch Intern Med. 1998 Feb 9;158(3):297. http://www.ncbi.nlm.nih.gov/pubmed/9472212

Laederach-Hofmann K, Glauser R. Paroxysmal tachycardia in a patient without panic disorder. Arch Intern Med. 1998 Apr 27;158(8):929. http://www.ncbi.nlm.nih.gov/pubmed/9570184

Calkins H, Ajit Kumar VK, Johnson F. Radiofrequency catheter ablation of supraventricular tachycardia. Indian pacing and electrophysiol J 2002 Apr 2(2):45. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1564051/

Andreassi JL. The psychophysiology of cardiovascular reactivity. Int J Psychophysiol. 1997;25:7–11.

Fichera LV, Andreassi JL. Cardiovascular reactivity during public speaking as a function of personality variables. Int J Psychophysiol.2000;37:267–73.

Fichera LV, Andreassi JL. Stress and personality as

factors in women’s cardiovascular reactivity. Int J Psychophysiol. 1998;28:143–55.

Frommeyer G, Eckardt L, Breithardt G. Panic attacks and supraventricular tachycardias: the chicken or the egg? Neth Heart J. Feb 2013; 21(2): 74–77. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547429/

Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., & Brooker, S. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 2013; 380(9859), 2163-2196. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61729-2/fulltext

Barsky, A. J. Palpitations, arrhythmias, and awareness of cardiac activity. Annals of internal medicine, 2001;134(9_Part_2), 832-837. http://www.ncbi.nlm.nih.gov/pubmed/11346318

Kitzlerová E, Anders M, Kautzner J, Dohnalová AI, Evaluation of psychopathology in patients with paroxysmal supraventricular tachycardia Exp Clin Cardiol. 2007 Spring; 12(1): 42–45. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2359618/

Parvan, K., Zamanzadeh, V., Dizaji, S. L., Shabestari, M. M., & Safaie, N. Patient’s Perception of Stressors Associated with Coronary Artery Bypass Surgery. Journal of cardiovascular and thoracic research 2013;5(3), 113. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825391/

Cupples, S. A., Paige-Dobson, B., & Armstrong III, D. Psychophysiological manifestations of anxiety in patients undergoing electrophysiology studies. Heart & Lung: The Journal of Acute and Critical Care, 1998;27(6), 374-386. http://www.ncbi.nlm.nih.gov/pubmed/9835669

Qiu, Y. G., Zhang, F. R., Chen, J. Z., Zhu, J. H., Tao, Q. M., Zheng, L. R., ... & Zhao, L. L. Psychological status and its influencing factors on patients undergoing electrophysiology studies and radiofrequency catheter ablation. Zhonghua liu xing bing xue za zhi Zhonghua liuxingbingxue zazhi, 2003; 24(10), 928-931. http://www.ncbi.nlm.nih.gov/pubmed/14575611

Wood, Kathryn A., et al. Patient perception of symptoms

and quality of life following ablation in patients with supraventricular tachycardia. Heart & Lung: The Journal of Acute and Critical Care 39.1 2010; 12-20. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825391/

Saririan M, Eisenberg MJ. Myocardial laser revascularisation for the treatment of end-stage coronary artery disease. J Am Coll Cardiol. 2003; 41:173–183. http://www.ncbi.nlm.nih.gov/pubmed/12535804

Gerstenfeld EP, Guerra P, Sparks PB, Hattori K, Lesh MD. Clinical outcome after radiofrequency catheter ablation of focal atrial fibrillation triggers. J Cardiovasc Electrophysiol. 2001; 12: 900–908. http://www.ncbi.nlm.nih.gov/pubmed/11513440

Berkowitsch A, Neumann T, Kurzidim K, Reiner C, Kuniss M, Siemon G, Sperzel J, Pitschner HF. Comparison of generic health survey SF-36 and arrhythmia related symptom severity check list in relation to post-ablation recurrence. Europace. 2003; 5: 351–355. http://www.ncbi.nlm.nih.gov/pubmed/14753629

Hindricks, G, Piorkowski, C, Tanner, H, Kobza, R, Gerds-Li, J H, Carbucicchio, C, Kottkamp H. Perception of Atrial Fibrillation Before and After Radiofrequency Catheter Ablation Relevance of Asymptomatic Arrhythmia Recurrence. Circulation, 2005. 112(3):307-313. http://www.ncbi.nlm.nih.gov/pubmed/16009793

Akbayrak, B. A comparison of two data collection methods: Interviews and questionnaires. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi, 2000;18, 1-10. http://www.efdergi.hacettepe.edu.tr/200018BURCU%20AKBAYRAK.pdf

ACC/ AHA/ ESC Guidelines for the Management of Patients with Supraventricular Arrythmias – Executive Summary. Circulation. 2003; 108:1871. http://www.escardio.org/guidelines-surveys/esc-guidelines/guidelinesdocuments/guidelines-sva-es.pdf

Downloads

Published

29-Nov-2014

How to Cite

El-Medany, A. Y. M., & Grubb, N. R. (2014). Supraventricular tachycardia and catheter ablation: Anxiety levels and patient perceptions. Res Medica, 22(1), 2–14. https://doi.org/10.2218/resmedica.v22i1.817

Issue

Section

Original Research Article