Education, and obtaining of informed consent, using multimedia before adults with congenitally malformed hearts are submitted to transcatheter interventions.
BACKGROUND
Multimedia programmes relating to education and consents may be useful for decreasing anxiety during catheter-based repair in patients with congenitally malformed hearts.


OBJECTIVE
Our study was aimed at evaluating the impact of multimedia protocols for education of a population of consecutive patients with congenitally malformed hearts prior to transcatheter repair.


METHODS
Between September, 2006, and May, 2008, we enrolled 100 consecutive patients, with a mean age of 45 +/- 19 years, of whom 69 were female, for catheter-based repair of their congenitally malformed hearts. In the first 50 patients, we used a written form for informed consent sent to the patients 15 days before the procedure, coupled with a personal interview of 30 minutes. In the subsequent 50 patients, we used multimedia protocol for education, comprising a booklet of 4 pages containing a simple and brief explanation of the intervention, and a digital film of 4 minutes showing the transcatheter procedure with a commentary provided by the referring physician, prior to obtaining the signature for informed consent. We then compared the scores for anxiety, the pre-operative heart rate, the frequency of vaso-vagal episodes, and the need for conscious sedation between the two groups.


RESULTS
Patients who underwent preconditioning using the multimedia programme were significantly less anxious, and had significantly lower heart rates. Vaso-vagal episodes were also significantly less in this group, with no episodes compared to 14% in those providing standard informed consent. Conscious sedation was needed more frequently in those providing standard informed consent.


CONCLUSIONS
Our brief study suggests that a comprehensive multimedia programme of preparation increases the tolerability, and decrease the emotional state, of adults about to undergo catheter-based interventions for congenital cardiac disease.
Rigatelli
Gianluca
G
Section of Adult Congenital and Structural Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. jackyheart@libero.it
Magro
Beatrice
B
Ferro
Susanna
S
Bedendo
Emiliano
E
Cominato
Sandra
S
Mantovan
Riccardo
R
Oliva
Laura
L
Giordan
Massimo
M
Dell'Avvocata
Fabio
F
Cardaioli
Paolo
P
D000328:Adult; D006328:Cardiac Catheterization; D016292:Procedural Sedation; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D010353:Patient Education as Topic