Health-related quality-of-life assessment of patients with life-threatening ventricular arrhythmias

The purpose of this study was to determine whether treatments for life-thre atening ventricular arrhythmias are associated with qualify-of-life (QOL) a nd psychological distress. Multidimensional measures of QOL and psychologic al distress were used to cross-sectionally compare patients with ICDs to pa tients treated with antiarrhythmic drugs and patients without serious cardi ac conditions. The sample consisted of 157 patients: 35 patients treated wi th antiarrhythmic medication only, 24 patients treated with ICD only, 25 pa tients treated with ICD and antiarrhythmic medication, and 73 controls. Pat ients completed the Medical Outcomes Study SF-36 health survey, the Brief S ymptom Inventory, and background questionnaires. There were no significant differences in self-reported QOL and psychological distress between patient s with or without ICD, and the occurrence of defibrillator shocks was unrel ated to QOL and psychological distress. However, patients treated with anti arrhythmic drugs reported greater QOL impairment in physical functioning, v itality, emotional role limitations, and sleep, as well as greater psycholo gical distress than patients not treated with antiarrhythmics. These limita tions may be attributed to adverse effects arising from antiarrhythmic phar macotherapy. Results of the present investigation suggest that QOL and psyc hological distress are maintained among ICD patients, whereas treatment wit h antiarrhythmic drugs are associated with a diminished QOL and greater psy chological distress. These findings may assist cardiologists to select the optimal treatment for life-threatening ventricular arrhythmias that minimiz es disturbances in health-related QOL and psychological distress and increa ses patient compliance.