Key result
Pre-ablation TEE causes oropharyngeal discomfort in ~76% of patients, driving strong preference for alternatives.
Why the study?
Unmet medical needs associated with atrium thrombus screening using TEE before planned RFCA in Chinese patients with AF needed to be surveyed.
What are the patient-reported experiences (anxiety, oropharynx pain, discomfort, satisfaction, preference for alternative technology) and economic impacts associated with transesophageal echocardiography prior to planned radio-frequency catheter ablation in patients with atrial fibrillation?
Cross-Sectional (n=300)
No
What are the patient-reported experiences (anxiety, oropharynx pain, discomfort, satisfaction, preference for alternative technology) and economic impacts associated with transesophageal echocardiography prior to planned radio-frequency catheter ablation in patients with atrial fibrillation?
Pre-ablation TEE in AF patients is associated with high rates of oropharyngeal pain (58.6%) and discomfort (76.2%) as well as increased inpatient length of stay and costs, driving an 84.3% patient preference for alternative thrombus-screening technologies such as intracardiac echocardiography.
TEE discomfort may support alternative screening evaluation; leaves open randomized comparisons of safety and outcomes.
Background: To survey the unmet medical needs associated with atrium thrombus screening in Chinese patients with atrial fibrillation (AF) who underwent transesophageal echocardiography (TEE) for planned radio-frequency catheter ablation (RFCA). Methods: This cross-sectional survey study interviewed 300 patients who underwent their first TEE for planned RFCA. The surveyed information included patients' anxiety, oropharynx pain and discomfort, time expense, and patient satisfaction related to TEE examination. Patient preference for a new atrium thrombus screening technology, hospital length of stay (LOS) of RFCA, and hospital costs of RFCA in these surveyed patients were collected as well. Descriptive statistical methods were used to summarize the collected survey information. Results: Of the 300 interviewed patients, 36.3% reported anxiety before TEE examination, 58.6% reported oropharynx pain related to TEE, and 76.2% reported oropharynx discomforts, mainly including foreign body sensation (54.3%), dry heaves (33.8%), nausea (31.9%), and bleeding (22.9%). Even though 62.3% were satisfied with TEE, 84.3% preferred a new technology to replace TEE. Conducting outpatient TEE took more wait time (4.4 days vs. 0.1 days, p = 0.016) but led to significantly shorter hospital LOS (3.8 days vs. 6.4 days, p < 0.001) and significant lower hospital costs for RFCA (¥74,097 vs. ¥85,843, p < 0.001) than conducting inpatient TEE. Conclusions: Most AF patients experienced oropharynx pain and discomfort during or after TEE. Although more than half of AF patients were satisfied with TEE, most AF patients preferred a new technology to replace TEE for atrium thrombus screening. TEE was associated with economic impact on RFCA irrespective of TEE conducting settings.
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Zeng et al. (2023) conducted a cross-sectional in Paroxysmal or persistent atrial fibrillation undergoing planned radio-frequency catheter ablation (n=300). Transesophageal echocardiography (TEE) under local anesthesia (including outpatient vs. inpatient setting comparison) vs. Inpatient TEE setting (for economic/time comparisons) was evaluated on Patient-reported outcomes (pre-TEE anxiety, oropharynx pain, oropharynx discomfort, satisfaction, and preference for new technology) and economic impact (hospital LOS and costs). Transesophageal echocardiography for planned AF ablation caused oropharynx pain in 58.6% and discomfort in 76.2% of patients, leading 84.3% to prefer an alternative screening technology.
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