Decreasing pain and anxiety associated with patient-activated atrial shock: A placebo-controlled study of adjunctive sedation with oral triazolam

Tanya J. Fabian, David S. Schwartzman, Michael R. Ujhelyi, Sharon E. Corey, Kristin Bigos, Bruce G. Pollock, Patricia D. Kroboth

Research output: Contribution to journalArticle

Abstract

Introduction: Implantable atrial defibrillators (IADs) have proved to be safe and effective in the management of atrial fibrillation. A potential limitation of self-activated IAD therapy is patient-reported pain and anxiety. The main objective of the present study was to determine whether triazolam improved patient perception of the shock experience or altered patient memory of shock discomfort relative to placebo. Methods and Results: A total of 15 men and women (mean age: 59 ± 6 years) were enrolled in this double-blind, placebo-controlled, crossover study of triazolam. Randomized study medication was administered orally 75 minutes prior to scheduled atrial shock delivery. Patient perception of the shock experience was assessed along with sedation, memory, anxiety, and mood. Triazolam reduced mean pre-shock anxiety (t= 2.98, df = 14, P = 0.01) and shock-related pain (t= 2.74, df = 13, P = 0.01) and intensity (t= 2.64, df = 13, P = 0.018) relative to placebo. Similarly, participants recalled less discomfort the morning after shock with triazolam than with placebo (t= 2.82, df = 11, P = 0.017). Conclusions: This study was the first to investigate the use of an oral benzodiazepine administered prior to patient-activated shock delivery with an IAD. Our data indicate that oral triazolam is beneficial in decreasing pain and anxiety associated with self-activated atrial defibrillation. If triazolam provides a similar benefit in the community to that which has been reported here, this medication could be offered to patients as an adjunct to intermittent IAD therapy.

Original languageEnglish (US)
Pages (from-to)391-395
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume17
Issue number4
DOIs
StatePublished - Apr 2006
Externally publishedYes

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Triazolam
Shock
Anxiety
Placebos
Pain
Implantable Defibrillators
Benzodiazepines
Cross-Over Studies
Atrial Fibrillation

Keywords

  • Anxiety
  • Atrial defibrillator
  • Atrial fibrillation
  • Pain
  • Sedation
  • Triazolam

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Decreasing pain and anxiety associated with patient-activated atrial shock : A placebo-controlled study of adjunctive sedation with oral triazolam. / Fabian, Tanya J.; Schwartzman, David S.; Ujhelyi, Michael R.; Corey, Sharon E.; Bigos, Kristin; Pollock, Bruce G.; Kroboth, Patricia D.

In: Journal of Cardiovascular Electrophysiology, Vol. 17, No. 4, 04.2006, p. 391-395.

Research output: Contribution to journalArticle

Fabian, Tanya J. ; Schwartzman, David S. ; Ujhelyi, Michael R. ; Corey, Sharon E. ; Bigos, Kristin ; Pollock, Bruce G. ; Kroboth, Patricia D. / Decreasing pain and anxiety associated with patient-activated atrial shock : A placebo-controlled study of adjunctive sedation with oral triazolam. In: Journal of Cardiovascular Electrophysiology. 2006 ; Vol. 17, No. 4. pp. 391-395.
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abstract = "Introduction: Implantable atrial defibrillators (IADs) have proved to be safe and effective in the management of atrial fibrillation. A potential limitation of self-activated IAD therapy is patient-reported pain and anxiety. The main objective of the present study was to determine whether triazolam improved patient perception of the shock experience or altered patient memory of shock discomfort relative to placebo. Methods and Results: A total of 15 men and women (mean age: 59 ± 6 years) were enrolled in this double-blind, placebo-controlled, crossover study of triazolam. Randomized study medication was administered orally 75 minutes prior to scheduled atrial shock delivery. Patient perception of the shock experience was assessed along with sedation, memory, anxiety, and mood. Triazolam reduced mean pre-shock anxiety (t= 2.98, df = 14, P = 0.01) and shock-related pain (t= 2.74, df = 13, P = 0.01) and intensity (t= 2.64, df = 13, P = 0.018) relative to placebo. Similarly, participants recalled less discomfort the morning after shock with triazolam than with placebo (t= 2.82, df = 11, P = 0.017). Conclusions: This study was the first to investigate the use of an oral benzodiazepine administered prior to patient-activated shock delivery with an IAD. Our data indicate that oral triazolam is beneficial in decreasing pain and anxiety associated with self-activated atrial defibrillation. If triazolam provides a similar benefit in the community to that which has been reported here, this medication could be offered to patients as an adjunct to intermittent IAD therapy.",
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T2 - A placebo-controlled study of adjunctive sedation with oral triazolam

AU - Fabian, Tanya J.

AU - Schwartzman, David S.

AU - Ujhelyi, Michael R.

AU - Corey, Sharon E.

AU - Bigos, Kristin

AU - Pollock, Bruce G.

AU - Kroboth, Patricia D.

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N2 - Introduction: Implantable atrial defibrillators (IADs) have proved to be safe and effective in the management of atrial fibrillation. A potential limitation of self-activated IAD therapy is patient-reported pain and anxiety. The main objective of the present study was to determine whether triazolam improved patient perception of the shock experience or altered patient memory of shock discomfort relative to placebo. Methods and Results: A total of 15 men and women (mean age: 59 ± 6 years) were enrolled in this double-blind, placebo-controlled, crossover study of triazolam. Randomized study medication was administered orally 75 minutes prior to scheduled atrial shock delivery. Patient perception of the shock experience was assessed along with sedation, memory, anxiety, and mood. Triazolam reduced mean pre-shock anxiety (t= 2.98, df = 14, P = 0.01) and shock-related pain (t= 2.74, df = 13, P = 0.01) and intensity (t= 2.64, df = 13, P = 0.018) relative to placebo. Similarly, participants recalled less discomfort the morning after shock with triazolam than with placebo (t= 2.82, df = 11, P = 0.017). Conclusions: This study was the first to investigate the use of an oral benzodiazepine administered prior to patient-activated shock delivery with an IAD. Our data indicate that oral triazolam is beneficial in decreasing pain and anxiety associated with self-activated atrial defibrillation. If triazolam provides a similar benefit in the community to that which has been reported here, this medication could be offered to patients as an adjunct to intermittent IAD therapy.

AB - Introduction: Implantable atrial defibrillators (IADs) have proved to be safe and effective in the management of atrial fibrillation. A potential limitation of self-activated IAD therapy is patient-reported pain and anxiety. The main objective of the present study was to determine whether triazolam improved patient perception of the shock experience or altered patient memory of shock discomfort relative to placebo. Methods and Results: A total of 15 men and women (mean age: 59 ± 6 years) were enrolled in this double-blind, placebo-controlled, crossover study of triazolam. Randomized study medication was administered orally 75 minutes prior to scheduled atrial shock delivery. Patient perception of the shock experience was assessed along with sedation, memory, anxiety, and mood. Triazolam reduced mean pre-shock anxiety (t= 2.98, df = 14, P = 0.01) and shock-related pain (t= 2.74, df = 13, P = 0.01) and intensity (t= 2.64, df = 13, P = 0.018) relative to placebo. Similarly, participants recalled less discomfort the morning after shock with triazolam than with placebo (t= 2.82, df = 11, P = 0.017). Conclusions: This study was the first to investigate the use of an oral benzodiazepine administered prior to patient-activated shock delivery with an IAD. Our data indicate that oral triazolam is beneficial in decreasing pain and anxiety associated with self-activated atrial defibrillation. If triazolam provides a similar benefit in the community to that which has been reported here, this medication could be offered to patients as an adjunct to intermittent IAD therapy.

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KW - Pain

KW - Sedation

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