Music in the cath lab: who should select it?

OBJECTIVES

The ALMUT study wants to evaluate the anxiolytic effects of different music styles and no music in 200 patients undergoing cardiac catheterization and to assess if there is a difference if patients select one of these therapies or are randomized to one of them.

BACKGROUND

The anxiolytic and analgesic effects of music have been described in previous trials. Some authors have suggested to evaluate whether patient-selected music is more effective than the music selected by the physician in reducing anxiety and stress levels.

METHODS AND RESULTS

After randomization 100 patients (group A) were allowed to choose between classical music, relaxing modern music, smooth jazz, and no music. One hundred patients (group B) were randomized directly to one of these therapies (n = 25 each). Complete data were available for 197 patients (65 ± 10 years; 134 male). Using the State-Trait Anxiety Inventory (STAI) all patients in group B who listened to music showed a significantly higher decrease of their anxiety level (STAI-State difference pre-post of 16.8 ± 10.2) compared to group A (13.3 ± 11.1; p = 0.0176). Patients without music (6.2 ± 6.7) had a significantly weaker reduction of anxiety compared to all music-listeners (14.9 ± 10.7, p < 0.0001).

CONCLUSIONS

The positive effects of music in the cath lab support previous reports. Surprisingly, the hypothesis that the patient's choice of preferred music might yield higher benefits than a randomized assignment could be dismissed.