Clinician Fatigue in Catheter Ablation Procedures V 1.0

• Research type

  Research Study

• Full title

  A study measuring neuromuscular and cognitive fatigue of clinicians performing catheter ablation procedures for the treatment of atrial fibrillation

• IRAS ID

  99527

• Contact name

  Emma Ross

• ISRCTN Number

  xx

• Research summary

  Catheter ablation is a medical procedure that aims to correct heart rhythm abnormalities (cardiac arrhythmias). Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increased risk of stroke, heart failure and mortality. The catheter ablation technique for the treatment of AF has evolved rapidly and is commonly performed in many hospitals worldwide. Since these procedures comprise long durations of intensive dexterous handling of operating equipment in conjunction with simultaneous attention on ultrasound and mapping images, it is hypothesised that they will result in cognitive and neuromuscular fatigue in the clinician performing them. This is pertinent as fatigue may compromise a clinician's performance in subsequent procedures, and it is common practice for clinicians to perform multiple AF catheter ablations in one day. Further, novel multi-electrode catheters with guidewires (PVAC©) have recently become available which reduce operating time and manual handling requirements during the procedure. Clinicians that are trained in both conventional and PVAC ablation techniques can select either method at their professional discretion. It is therefore also important to investigate whether there is a difference in the magnitude of fatigue experienced following each procedure type. Clinicians currently utilizing both techniques on an NHS site are eligible for this study. A short fatigue assessment protocol will be used to measure the neuromuscular and cognitive status of the clinician before and immediately after an ablation procedure. This assessment includes transcranial magnetic stimulation (TMS), a non-invasive and painless stimulation technique to investigate the functioning of the pathway between the brain and hand muscles, and computer based reaction time and coordination control tasks. The findings of the proposed study will provide important information regarding neuromuscular and cognitive disturbances as a result of different catheter ablation techniques, which could affect performance in consecutive procedures that day. The study is funded by Medtronic Ltd.

• REC name

  London - Brent Research Ethics Committee

• REC reference

  12/LO/1460

• Date of REC Opinion

  2 Oct 2012

• REC opinion

  Favourable Opinion