34 A quality assessment of atrial fibrillation catheter ablation material on youtube; do they contain sufficient information to act as an appropriate patient resource?

Introduction Catheter ablation forms a central role in the treatment of selected patients with atrial fibrillation (AF). However, ablation is an invasive procedure with a range of potential complications some of which are serious. Patients are increasingly utilising the internet as a resource for medical information. YouTube, the world’s largest video repository, is a key source of readily available information. However, there are limited controls on the information posted on YouTube. To this end, the aim of this project was to determine the quality of videos discussion AF catheter ablation on YouTube. Methods YouTube was searched for Ablation and one of Atrial Fibrillation or AFib or AF (a total of three searches). The first 20 pages of results from each search were reviewed by two authors who viewed the whole video and selected those for inclusion. Videos were included if they discussed catheter ablation. Videos were excluded if they primarily discussed surgical or hybrid ablation or were exclusively a patient experience video. Videos from related YouTube channels were also reviewed to ensure all videos from a presumed series were included. Each video was scored by two authors for compliance with a gold-standard item set created from patient booklets from the Arrhythmia Alliance. Any disagreements between authors at any stage were resolved through consensus; if consensus could not be reached a third author acted as the tie-break. Results A total of 400 videos from each search were manually reviewed. Of these, a total of 111 videos met inclusion criteria and were included in the analysis (Figure 1). The median number of views for each video was 1915 (IQR 335 to 10,972) with a median duration of 216 s (IQR 135 to 472 s). AF as a condition was explained in 52 videos (47%) and 60 videos (54%) explained that catheter ablation involved isolation of abnormal electrical activity. Procedural risks were discussed in 49 videos (44%) with stroke and death mentioned as potential risks in only 14 (13%) and 12 (11%) videos respectively. Medication as an alternative therapy was discussed in 57 (51%) videos. Success rates were provided in 32 (28%) videos; in these videos success rates ranged from 30% to 95%. A list of essential criteria assessed is outlined in table 1; no video complied with all essential criteria. Conclusions There are a large number of videos providing information to patients on catheter ablation for atrial fibrillation. However, no video provides sufficiently detailed information for a patient to have a reasonable understanding of catheter ablation. This research suggests that the development of an appropriate freely-available video resource regarding catheter ablation is of importance to ensure patients are able to obtain sufficient information online.