Pain during cardiac implantable electronic device implantation

Area of Science:

• Cardiology
• Pain Management
• Medical Devices

Background:

• Cardiac implantable electronic devices (CIEDs) are crucial for managing various cardiac conditions.
• Patient comfort during CIED implantation procedures is an important aspect of care.
• Understanding pain perception and its contributing factors is essential for optimizing patient experience.

Purpose of the Study:

• To assess the prevalence and severity of pain during CIED implantation.
• To identify factors associated with increased pain during these procedures.
• To inform strategies for improving patient comfort during CIED implantation.

Main Methods:

• A prospective audit was conducted over 23 months.
• Patient self-reporting questionnaires were used to collect pain scores.
• Data from 599 CIED implantation procedures were analyzed.

Main Results:

• The median pain score was 2/10, with 61.6% reporting no or mild pain (0-3/10).
• Moderate pain (4-6/10) was reported by 27.7%, and severe pain (7-10/10) by 10.7% of patients.
• Significant pre-implant worry (OR 2.13) and higher lidocaine doses (OR 1.06) were associated with severe pain.

Conclusions:

• Most patients experience minimal pain during CIED implantation.
• A notable minority report severe pain, highlighting the need for better pain management strategies.
• Further research into reducing pre- and peri-implant anxiety, especially in women receiving ICDs, is warranted to enhance patient comfort.