Key result
BCI-based app-delivered mindfulness meditation significantly reduced numeric rating scale scores (4.6 vs 5.7; P=0.008) and State Anxiety Inventory scores (36.7 vs 42.3; P<0.001) during RFCA.
Why the study?
Radiofrequency catheter ablation for atrial fibrillation can cause considerable physical and psychological discomfort under conscious sedation, and app-based mindfulness meditation with an electroencephalography-based brain-computer interface may serve as an effective adjunct.
Does BCI-based app-delivered mindfulness meditation improve physical and psychological discomfort in patients with atrial fibrillation undergoing radiofrequency catheter ablation?
RCT (n=84)
1:1
No
Does BCI-based app-delivered mindfulness meditation improve physical and psychological discomfort in patients with atrial fibrillation undergoing radiofrequency catheter ablation?
Absolute Event Rate: 4.6% vs 5.7%
p-value: p=.008
An EEG-based brain-computer interface mindfulness meditation app significantly reduces patient-reported pain, anxiety, fatigue, and fentanyl requirements during AF ablation under conscious sedation.
May improve comfort during conscious-sedation AF ablation; extends RCT evidence for app-based mindfulness in electrophysiology.
BACKGROUND Radiofrequency catheter ablation (RFCA) for patients with atrial fibrillation (AF) can generate considerable physical and psychological discomfort under conscious sedation. App-based mindfulness meditation combined with an electroencephalography (EEG)-based brain-computer interface (BCI) shows promise as effective and accessible adjuncts in medical practice. OBJECTIVE This study aimed to investigate the effectiveness of a BCI-based mindfulness meditation app in improving the experience of patients with AF during RFCA. METHODS This single-center pilot randomized controlled trial involved 84 eligible patients with AF scheduled for RFCA, who were randomized 1:1 to the intervention and control groups. Both groups received a standardized RFCA procedure and a conscious sedative regimen. Patients in the control group were administered conventional care, while those in the intervention group received BCI-based app–delivered mindfulness meditation from a research nurse. The primary outcomes were the changes in the numeric rating scale, State Anxiety Inventory, and Brief Fatigue Inventory scores. Secondary outcomes were the differences in hemodynamic parameters (heart rate, blood pressure, and peripheral oxygen saturation), adverse events, patient-reported pain, and the doses of sedative drugs used in ablation. RESULTS BCI-based app–delivered mindfulness meditation, compared to conventional care, resulted in a significantly lower mean numeric rating scale (mean 4.6, SD 1.7 [app-based mindfulness meditation] vs mean 5.7, SD 2.1 [conventional care]; P=.008), State Anxiety Inventory (mean 36.7, SD 5.5 vs mean 42.3, SD 7.2; P<.001), and Brief Fatigue Inventory (mean 3.4, SD 2.3 vs mean 4.7, SD 2.2; P=.01) scores. No significant differences were observed in hemodynamic parameters or the amounts of parecoxib and dexmedetomidine used in RFCA between the 2 groups. The intervention group exhibited a significant decrease in fentanyl use compared to the control group, with a mean dose of 3.96 (SD 1.37) mcg/kg versus 4.85 (SD 1.25) mcg/kg in the control group (P=.003).The incidence of adverse events was lower in the intervention group (5/40) than in the control group (10/40), though this difference was not significant (P=.15). CONCLUSIONS BCI-based app–delivered mindfulness meditation effectively relieved physical and psychological discomfort and may reduce the doses of sedative medication used in RFCA for patients with AF. CLINICALTRIAL ClinicalTrials.gov NCT05306015; https://clinicaltrials.gov/ct2/show/NCT05306015
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He et al. (2022) conducted an RCT in Atrial Fibrillation (n=84). BCI-based app-delivered mindfulness meditation vs. Conventional care was evaluated on Changes in the numeric rating scale, State Anxiety Inventory, and Brief Fatigue Inventory scores (p=.008). BCI-based app-delivered mindfulness meditation significantly reduced numeric rating scale scores (4.6 vs 5.7; P=0.008) and State Anxiety Inventory scores (36.7 vs 42.3; P<0.001) during RFCA.
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