Anxiety in patients with an automatic implantable cardioverter defibrillator: What differentiates them from panic patients?

0Objective: Anxiety seems to be a frequent problem in patients with an auto matic implantable cardioverter defibrillator (AICD). Distressing experience s before or after AICD implantation such as resuscitation, or AICD shocks a re suspected as causes for enhanced anxiety levels. A closer examination of the level and structure of anxiety in AICD patients and a comparison with panic patients might help to examine additionally both conditioning and cog nitive models of anxiety, Methods: There were 61 AICD patients examined wit h a specifically designed AICD questionnaire and standardized anxiety and d epression questionnaires. Subgroups of AICD patients without, with some, an d with definite anxiety related to AICD shocks were compared with panic pat ients and healthy control subjects, Results: Although fear of dying was gre atly reduced by AICD implantation, approximately one third of the AICD pati ents, especially patients with definite anxiety related to AICD shocks, wer e characterized both by enhanced anxiety levels and avoidance behavior. The se patients were comparable with panic patients in most questionnaire score s. Anxiety levels were not associated with objective AICD shock experiences or medical variables. Conclusions: Anxiety in AICD patients seems to be un related to traumatic experiences, a finding that casts doubt on pure condit ioning models of anxiety. Presumably, a life-threatening cardiac disorder i ncreases the likelihood for catastrophic interpretations of bodily signs, e specially in anxiety prone AICD patients. In accordance with cognitive mode ls of panic disorder, this cognitive dysfunction could lead to anxiety and depression levels comparable with those of panic patients.