How different from pacemaker patients are recipients of implantable cardioverter-defibrillators with respect to psychosocial adaptation, affective disorders, and quality of life?
F. Duru et al., How different from pacemaker patients are recipients of implantable cardioverter-defibrillators with respect to psychosocial adaptation, affective disorders, and quality of life?, HEART, 85(4), 2001, pp. 375-379
Citations number
20
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objective-To assess differences in psychosocial adaptation, quality of life
, and incidence of affective disorders between patients with pacemakers and
those with implantable cardioverter-defibrillators (ICDs).
Design-Patients aged 40-70 years who underwent a first pectoral implantatio
n of a pacemaker or an ICD system were studied. All subjects were asked to
complete the hospital anxiety and depression scale (HAD), the short form ge
neral health survey (SF-36), and a specially designed device related questi
onnaire. Data analysis was performed for three patient groups: pacemaker (n
= 76), ICD patients who received therapeutic shocks (n = 45), and ICD pati
ents who did not receive shocks (n = 31).
Results-There were no differences between the three patient groups in HAD s
cores or in any of the SF-36 subscales or summary ratings. Probable depress
ive disorder (depression score > 10) was observed in 5.2%, 6.5%, and 6.6%,
and probable anxiety disorder (anxiety score > 10) In 13.1%, 9.7%, 13.3% of
the pacemaker, non-shocked ICD, and shocked ICD patients, respectively. Th
ere were no sex differences. However, patients in the shocked ICD group wer
e more likely than those in the other groups to report limitations in their
leisure activities, to perceive their device as a "life extender," and to
admit anxiety about battery depletion and technical problems. Forty per cen
t of shocked ICD patients would be interested in joining a support group.
Conclusions-Despite having distinctly different medical histories and treat
ments, patients with pacemakers and ICDs responded similarly to validated t
ools of health status assessment; ICD patients who had received shocks perc
eived their device as prolonging their life and had greater anxiety about t
echnical problems. Their endorsement of the potential benefits of a support
group warrants further investigation.