1
|
Galo J, Feroze R, Almas T, Morera J, Sahadevan J. Understanding Phantom Shocks in Implantable Cardioverter-Defibrillator Recipients. Cureus 2024; 16:e53161. [PMID: 38420102 PMCID: PMC10900171 DOI: 10.7759/cureus.53161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Phantom shocks in implantable cardioverter-defibrillator (ICD) recipients create a complex nexus between cardiac treatment and psychological distress. These sensations, mimicking therapeutic shocks without device activation, deeply affect patients' functionality and well-being. Heightened anxiety, depression, and hopelessness predispose individuals to these occurrences, posing significant challenges. This article delves into the intricate nature of phantom shocks, highlighting subtle clinical cues to differentiate them from genuine therapy shocks. Through a case study of a 75-year-old male with recurrent ICD shocks, diagnosed eventually with phantom shocks, the interplay between psychological distress and physical sensations is underscored. Urgent intervention to address the patient's anxiety and depression using psychotherapy and antidepressants became imperative. The case underscores the immense psychological toll of phantom shocks, exacerbating fear, hopelessness, and post-traumatic stress disorder (PTSD). Despite treatment attempts, their impact persisted, leading to a shift to comfort-focused care. While research identifies factors such as education levels and prior therapy, predicting and managing phantom shocks remains challenging. This article stresses the need for clinician vigilance, urging proactive identification and tailored interventions to mitigate the profound effects of phantom shocks. The current research landscape lacks comprehensive strategies, necessitating further exploration and targeted therapies to restore patient well-being. In conclusion, comprehensive understanding and specialized care for phantom shocks in ICD recipients, addressing both cardiac and psychological aspects, are imperative. Early recognition and tailored interventions offer promise in alleviating their adverse effects, reinstating patient control, and improving their quality of life.
Collapse
Affiliation(s)
- Jason Galo
- Cardiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, USA
| | - Rafey Feroze
- Cardiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, USA
| | - Talal Almas
- Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, USA
| | | | | |
Collapse
|
2
|
Yang W, Xu YL, Gao JQ, Shen D, Li M, Fa JJ, Zhang Y, Wang R, Hou SX, Hu WY, Jin HG, Liu ZJ. Effects of renal denervation therapy on cardiac function and malignant arrhythmia in patients with reduced left ventricular ejection fraction and narrow QRS complexes treated with implantable cardioverter defibrillator. Front Physiol 2022; 13:938486. [PMID: 36035484 PMCID: PMC9412050 DOI: 10.3389/fphys.2022.938486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/27/2022] [Indexed: 12/03/2022] Open
Abstract
Objective : The purpose of this study was to explore the effects of renal denervation (RDN) on cardiac function and malignant arrhythmia in patients with reduced left ventricular ejection fraction (HFrEF) and narrow QRS treated with an implantable cardioverter defibrillator (ICD). Methods: A total of 20 eligible HFrEF patients [left ventricular ejection fraction (LVEF) <40%] and narrow QRS complexes (QRS duration <120 ms) were randomized into either the ICD plus RDN group or the ICD only group during 17 April 2014 to 22 November 2016. Clinical data, including clinical characteristics, blood biochemistry, B-type natriuretic peptide, echocardiographic indexes, 6-min walk distance (6MWD), New York Heart Association (NYHA) classification, and count of ICD discharge events before and after the operation were analyzed. Patients were followed up for up to 3 years post ICD or ICD plus RDN. Results: Baseline clinical data were comparable between the two groups. Higher LVEF (%) (mixed model repeated measure, p = 0.0306) (39.50% ± 9.63% vs. 31.20% ± 4.52% at 1 year; 41.57% ± 9.62% vs. 31.40% ± 8.14% at 3 years), systolic blood pressure (p = 0.0356), and longer 6MWD (p < 0.0001) as well as reduction of NYHA classification (p < 0.0001) were evidenced in the ICD plus RDN group compared to ICD only group during follow-up. Patients in the ICD plus RDN group experienced fewer ICD discharge events (2 vs. 40) and decreased diuretic use; rehospitalization rate (30% vs. 100%, p = 0.0031) and cardiogenic mortality rate (0% vs. 50%, p = 0.0325) were also significantly lower in the ICD plus RDN group than in the ICD only group during follow-up. Conclusion: ICD implantation plus RDN could significantly improve cardiac function and cardiac outcome as well as increase exercise capacity compared to ICD only for HFrEF patients with narrow QRS complexes.
Collapse
Affiliation(s)
- Wei Yang
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Cardiology, Shanghai Putuo Central School of Clinical Medicine, Anhui Medical University/The Fifth School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - You-Long Xu
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun-Qing Gao
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Deng Shen
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Li
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing-Jing Fa
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Zhang
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Wang
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shu-Xin Hou
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-Ying Hu
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui-Gen Jin
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zong-Jun Liu
- Department of Cardiology, Putuo Hospital, Shanghai Putuo District Central Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Cardiology, Shanghai Putuo Central School of Clinical Medicine, Anhui Medical University/The Fifth School of Clinical Medicine, Anhui Medical University, Hefei, China
| |
Collapse
|
3
|
Wilkoff BL, Sterns LD, Katcher MS, Upadhyay G, Seizer P, Kang C, Rhude J, Davis KJ, Fischer A. Novel ventricular tachyarrhythmia detection enhancement detects undertreated life-threatening arrhythmias. Heart Rhythm O2 2021; 3:70-78. [PMID: 35243438 PMCID: PMC8859789 DOI: 10.1016/j.hroo.2021.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
4
|
Delle Donna P, Petrovic L, Nasir U, Ahmed A, Suero-Abreu GA. Phantom Shocks Associated With a Wearable Cardioverter Defibrillator. J Med Cases 2021; 12:49-53. [PMID: 34434428 PMCID: PMC8383611 DOI: 10.14740/jmc3606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/07/2020] [Indexed: 11/11/2022] Open
Abstract
Wearable cardioverter defibrillators (WCDs) are external devices capable of continuous cardiac rhythm monitoring as well as automatic detection and defibrillation of potentially life-threatening arrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF). They are an alternative approach for patients when an implantable cardioverter defibrillator (ICD) is not appropriate. Although treatment with ICD is considered highly effective for the primary and secondary prevention of sudden cardiac death (SCD) in high-risk patients susceptible to VT and VF, patients may still experience psychological difficulties such as fear of shock, avoidance of normal behaviors and reduced quality of life. One of these phenomena is phantom shock (PS), which is defined as a perception of having received a shock with no evidence of recorded defibrillation upon device interrogation. While PS has been reported in the ICD literature, to the best of our knowledge, we present the first known case of WCD-related PS. We also present a review of the current literature to explore the prevalence of PS, the factors associated with its pathogenesis and interventional studies aimed at reducing its occurrence. We highlight this case because PS is considered a phenomenon that few recognize, which should be discriminated from real device shocks before clinicians initiate treatment, device reprogramming or device discontinuation. We describe the psychosocial factors associated with PS to emphasize the importance of managing any associated psychiatric disorders and psychosocial factors both before and after initiation of device treatment.
Collapse
Affiliation(s)
- Paul Delle Donna
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Luka Petrovic
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Umair Nasir
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Ahmed Ahmed
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | |
Collapse
|
5
|
Cakulev I, Mackall JA. One size fits all, or do we have to rethink optimal programming in implantable cardioverter-defibrillators implanted for secondary prevention? Heart Rhythm O2 2020; 1:83-84. [PMID: 34115051 PMCID: PMC8183955 DOI: 10.1016/j.hroo.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ivan Cakulev
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Judith A. Mackall
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
6
|
Phantom shocks in implantable cardioverter-defibrillator recipients: impact of education level, anxiety, and depression. Herzschrittmacherther Elektrophysiol 2019; 30:306-312. [PMID: 31440897 DOI: 10.1007/s00399-019-00645-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/12/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Implantable cardioverter defibrillators (ICDs) are designed to deliver shocks in the event of ventricular arrhythmias. Some ICD recipients experience the sensation of ICD discharge in the absence of an actual discharge (phantom shock, PS). OBJECTIVES The aim of this study was to evaluate the incidence, predictors, and consequences of PS in ICD recipients. MATERIALS AND METHODS Consecutive ICD recipients were examined during a routine outpatient follow-up (FU) visit. Subjects completed a written survey; their level of depression and anxiety was assessed with the hospital anxiety and depression scale (HADS). Quality of life (QOL) was assessed using the Minnesota living with heart failure questionnaire. RESULTS Of 434 patients invited to the study, 423 (97.5%) ICD recipients agreed to and completed the survey; 349 (83%) had a primary prevention indication and 339 (80%) ischemic cardiomyopathy. A total of 27 patients (6.4%) reported a PS during a mean FU of 64 ± 44 months (5.4% in the primary prevention group and 10.8% in the secondary prevention group; p = 0.11). PS were related to higher education (≥bachelor's degree 41% versus 20%; p = 0.03), and more frequent in patients receiving adequate shocks during FU (34% versus 0.5%; p < 0.001). HADS score levels were higher following PS (15 ± 6 versus 8.8 ± 7.4; p < 0.001). The majority of patients reporting PS felt that the information provided to them prior to ICD placement was insufficient (22.2% versus 5.0%), that they needed psychological support after ICD implantation (26% versus 3%), and considered ICD deactivation in near end-of-life situations (59% versus 29%; p < 0.001 for all). CONCLUSIONS PS occur in 6.4% of all ICD recipients and are related to higher education and to patients that experienced adequate shocks during FU.
Collapse
|
7
|
Abstract
Implantable cardioverter-defibrillators have become standard preventive treatment for patients with ventricular arrhythmias and other life-threatening cardiac conditions. The advantages and efficiency of the device are supported by multiple clinical trials and outcome studies, leading to its popularity among cardiologists. Implantation of the device is not without adverse outcomes. Implantable cardioverter-defibrillator placement has been found to lead to negative psychological and psychosocial sequelae such as apprehension to engage in physical activity, chronic anxiety, decreased physical and social functioning, a nagging fear of being shocked by the device, and the development of "phantom shocks." Defined as patient-reported shocks in the absence of evidence that the implantable cardioverter-defibrillator device has discharged, phantom shocks could impact the mental health of those affected. This article reviews the case of Mr. L, a 47-year-old man with ischemic cardiomyopathy who was seen by the psychiatry consultation team while under cardiologic care because he reported that his implantable cardioverter-defibrillator device had been shocking him despite no objective evidence after interrogating the device. A literature review of phantom shocks, their associated symptomatology, and psychological consequences are outlined and discussed.
Collapse
Affiliation(s)
| | | | - Seth Himelhoch
- 3 Department of Psychiatry, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Anique Forrester
- 4 Division of Consultation-Liaison Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
8
|
Ooi SL, Seah B, Wu VX, Koh KWL, Jiao N, He HG, Wang W. Perceptions of Singaporean patients living with implantable cardioverter defibrillators: an exploratory qualitative study. Heart Lung 2018; 47:329-336. [DOI: 10.1016/j.hrtlng.2018.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
|
9
|
House LM, McKay RE, Eagan JT, McCormick ZL. Nocturnal phantom shock cessation with zolpidem. Heart Lung 2017; 47:76-79. [PMID: 29128111 DOI: 10.1016/j.hrtlng.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
A 77 year old man with a biventricular ICD-pacemaker complained of painful, electric jolts disturbing him nightly from sleep. Extensive work-up including device interrogation revealed no defibrillations or arrhythmia, and he was subsequently diagnosed with phantom shocks (PS). His nightly PS symptoms terminated after starting zolpidem 10 mg each night. To date, literature review reveals fifteen articles reporting 163 phantom shock (PS) cases. PS affects 5-9% of ICD recipients. Risk factors include psychiatric disease, atrial fibrillation, NYHA functional status III or greater, prior shock storm, and intraoperative awareness during ICD placement, with defibrillation threshold testing. This report describes a successful PS intervention, and reviews the current knowledge available in the pathophysiology and treatment of PS.
Collapse
Affiliation(s)
- Lawrence McLean House
- Anesthesia and Perioperative Care, University of California, San Francisco, Science Building, Room S-257, 513 Parnassus Ave, San Francisco, CA 94143-0542, USA.
| | - Rachel E McKay
- Anesthesia and Perioperative Care, University of California, San Francisco, Science Building, Room S-257, 513 Parnassus Ave, San Francisco, CA 94143-0542, USA
| | - John Thomas Eagan
- Interventional Cardiology, Cardiovascular Associates of the Southeast, LLC, 3980 Colonnade Pkwy, Birmingham, AL 35243, USA
| | - Zachary L McCormick
- Physical Medicine and Rehabilitation, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| |
Collapse
|
10
|
Ooi SL, He HG, Dong Y, Wang W. Perceptions and experiences of patients living with implantable cardioverter defibrillators: a systematic review and meta-synthesis. Health Qual Life Outcomes 2016; 14:160. [PMID: 27855698 PMCID: PMC5114828 DOI: 10.1186/s12955-016-0561-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 11/09/2016] [Indexed: 01/30/2024] Open
Abstract
Background Sudden cardiac deaths have become a growing major public health concern that affects the world. Despite the various etiologies, life-threatening cardiac arrhythmias attribute the main cause of sudden cardiac deaths. Therefore in certain groups of high-risk patients, the Implantable Cardioverter Defibrillator (ICD) has been recommended as either a secondary or primary prophylactic method of prevention. Objective To summarise the perceptions of ICD recipients and provide an overview of their experiences with regards to the quality of life, coping strategies, and learning needs. Methods A systematic search was conducted using CINAHL, MEDLINE, PsycINFO, Scopus, Cochrane Library, and Web of Science. Primary research articles published from January 2005 to January 2016 that met the inclusion criteria were selected and assessed for methodological quality. Results Thirty-nine articles consisting of 16 qualitative studies, 22 quantitative studies, and 1 mixed methods study were included for the meta-synthesis. Findings extracted from these studies were grouped into eight subthemes with ‘living the ICD experience: a constant process of redefining oneself’ emerging as an over-arching theme. Conclusion This review provides insight into the perspectives and experiences of ICD recipients. Current evidence highlights the need for healthcare professionals to improve future care standards and develop a patient-centric holistic program that meets the specific needs of ICD recipients. Moreover, future studies are required to address the research gaps identified and also explore the perceptions of patients living with ICD in the Asian context.
Collapse
Affiliation(s)
- Sim Leng Ooi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, Singapore
| | - Yanhong Dong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore, Singapore.
| |
Collapse
|
11
|
Wilkoff BL, Fauchier L, Stiles MK, Morillo CA, Al-Khatib SM, Almendral J, Aguinaga L, Berger RD, Cuesta A, Daubert JP, Dubner S, Ellenbogen KA, Estes NAM, Fenelon G, Garcia FC, Gasparini M, Haines DE, Healey JS, Hurtwitz JL, Keegan R, Kolb C, Kuck KH, Marinskis G, Martinelli M, McGuire M, Molina LG, Okumura K, Proclemer A, Russo AM, Singh JP, Swerdlow CD, Teo WS, Uribe W, Viskin S, Wang CC, Zhang S. 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. J Arrhythm 2016; 32:1-28. [PMID: 26949427 PMCID: PMC4759125 DOI: 10.1016/j.joa.2015.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Key Words
- AF, atrial fibrillation
- ATP, antitachycardia pacing
- Bradycardia mode and rate
- CI, confidence interval
- CL, cycle length
- CRT, cardiac resynchronization therapy
- CRT-D, cardiac resynchronization therapy–defibrillator
- DT, defibrillation testing
- Defibrillation testing
- EEG, electroencephalography
- EGM, electrogram
- HF, heart failure
- HR, hazard ratio
- ICD, implantable cardioverter-defibrillator
- Implantable cardioverter-defibrillator
- LV, left ventricle
- LVEF, left ventricular ejection fraction
- MI, myocardial infarction
- MVP, managed ventricular pacing
- NCDR, National Cardiovascular Data Registry
- NYHA, New York Heart Association
- OR, odds ratio
- PEA, peak endocardial acceleration
- PVC, premature ventricular contraction
- Programming
- RCT, randomized clinical trial
- RV, right ventricle
- S-ICD, subcutaneous implantable cardioverter-defibrillator
- SCD, sudden cardiac death
- SVT, supraventricular tachycardia
- TIA, transient ischemic attack
- Tachycardia detection
- Tachycardia therapy
- VF, ventricular fibrillation
- VT, ventricular tachycardia (Heart Rhythm 2015;0:1–37)
- aCRT, adaptive cardiac resynchronization therapy
Collapse
Affiliation(s)
| | | | | | - Carlos A Morillo
- Department of Medicine, Cardiology Division, McMaster University-Population Health Research Institute, Hamilton, Canada
| | | | - Jesœs Almendral
- Grupo HM Hospitales, Universidad CEU San Pablo, Madrid, Spain
| | | | | | - Alejandro Cuesta
- Servicio de Arritmias, Instituto de Cardiologia Infantil, Montevideo, Uruguay
| | | | - Sergio Dubner
- Clinica y Maternidad Suizo Argentina; De Los Arcos Sanatorio, Buenos Aires, Argentina
| | | | | | | | - Fermin C Garcia
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - David E Haines
- William Beaumont Hospital Division of Cardiology, Royal Oak, Michigan
| | - Jeff S Healey
- Department of Medicine, Cardiology Division, McMaster University-Population Health Research Institute, Hamilton, Canada
| | | | | | | | | | | | | | | | - Luis G Molina
- Mexico's National University, Mexico's General Hospital, Mexico City, Mexico
| | - Ken Okumura
- Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Alessandro Proclemer
- Azienda Ospedaliero Universitaria S. Maria della Misericordia- Udine, Udine, Italy
| | | | - Jagmeet P Singh
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Wee Siong Teo
- National Heart Centre Singapore, Singapore, Singapore
| | - William Uribe
- CES Cardiología and Centros Especializados San Vicente Fundación, Medellín y Rionegro, Colombia
| | - Sami Viskin
- Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shu Zhang
- National Center for Cardiovascular Disease and Beijing Fu Wai Hospital, Peking Union Medical College and China Academy of Medical Sciences, Beijing, China
| |
Collapse
|
12
|
Amiaz R, Asher E, Rozen G, Czerniak E, Glikson M, Weiser M. Do implantable cardioverter defibrillators contribute to new depression or anxiety symptoms? A retrospective study. Int J Psychiatry Clin Pract 2016; 20:101-5. [PMID: 27052573 DOI: 10.3109/13651501.2016.1161055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In this retrospective cross-sectional study, we evaluated the existence of psychiatric symptoms which appeared after implantation of an implantable cardioverter defibrillator (ICD). METHODS Patients with ICDs were diagnosed using the Mini International Neuropsychiatric Interview (MINI) and were excluded if they had any psychiatric diagnosis prior to ICD implantation. Depression and anxiety were evaluated using the HAM-D and HAM-A rating scales and their attitude towards the ICD using a visual analog scale (VAS). Ninety five ICD patients with mean age of 66 years (±11.5) were recruited, 80 (84%) were men. RESULTS Four (4%) patients were diagnosed with new-onset MDD and one patient (1%) with anxiety. Twenty seven (28%) were found to have significant depressive symptoms (HAM-D >8), without MDD diagnosis; half of them attributing these symptoms to the device. Seven (8%) patients experienced phantom shocks and had relatively higher depressive scores (HAM-D 10.3 vs. 5.8; F = 3.696; p = 0.058). The MDD rates in our study were rather consistent with those reported for cardiac patients. CONCLUSIONS We suggest that ICD contributed little, if any, additional depressive or anxiety symptoms after implantation. We found that the overall attitude towards the device was positive and that shocks and phantom shocks were related to depressive symptoms.
Collapse
Affiliation(s)
- Revital Amiaz
- a Psychiatry Department , The Chaim Sheba Medical Center , Tel Hashomer , Israel ;,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Elad Asher
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel ;,c Davidai Arrhythmia Center, Leviev Heart Center, The Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Guy Rozen
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel ;,c Davidai Arrhythmia Center, Leviev Heart Center, The Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Efrat Czerniak
- a Psychiatry Department , The Chaim Sheba Medical Center , Tel Hashomer , Israel ;,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Michael Glikson
- b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel ;,c Davidai Arrhythmia Center, Leviev Heart Center, The Chaim Sheba Medical Center , Tel Hashomer , Israel
| | - Mark Weiser
- a Psychiatry Department , The Chaim Sheba Medical Center , Tel Hashomer , Israel ;,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| |
Collapse
|
13
|
2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Heart Rhythm 2015; 13:e50-86. [PMID: 26607062 DOI: 10.1016/j.hrthm.2015.11.018] [Citation(s) in RCA: 179] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Indexed: 12/12/2022]
|
14
|
Wilkoff BL, Fauchier L, Stiles MK, Morillo CA, Al-Khatib SM, Almendral J, Aguinaga L, Berger RD, Cuesta A, Daubert JP, Dubner S, Ellenbogen KA, Estes NAM, Fenelon G, Garcia FC, Gasparini M, Haines DE, Healey JS, Hurtwitz JL, Keegan R, Kolb C, Kuck KH, Marinskis G, Martinelli M, Mcguire M, Molina LG, Okumura K, Proclemer A, Russo AM, Singh JP, Swerdlow CD, Teo WS, Uribe W, Viskin S, Wang CC, Zhang S. 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Europace 2015; 18:159-83. [PMID: 26585598 DOI: 10.1093/europace/euv411] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
15
|
Lane DA, Aguinaga L, Blomström-Lundqvist C, Boriani G, Dan GA, Hills MT, Hylek EM, LaHaye SA, Lip GYH, Lobban T, Mandrola J, McCabe PJ, Pedersen SS, Pisters R, Stewart S, Wood K, Potpara TS, Gorenek B, Conti JB, Keegan R, Power S, Hendriks J, Ritter P, Calkins H, Violi F, Hurwitz J. Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Europace 2015; 17:1747-69. [PMID: 26108807 DOI: 10.1093/europace/euv233] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
16
|
Cantillon DJ, Wilkoff BL. Antitachycardia pacing for reduction of implantable cardioverter-defibrillator shocks. Heart Rhythm 2015; 12:1370-5. [PMID: 25708880 DOI: 10.1016/j.hrthm.2015.02.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Indexed: 12/11/2022]
Abstract
Antitachycardia pacing (ATP) strategies represent safe, effective, and painless therapy for ventricular tachyarrhythmias, with a large body of clinical evidence supporting their routine use in both primary and secondary implantable cardioverter-defibrillator recipients. This article details the evidence supporting the use of standardized and validated ATP strategies for primary prevention patients and the conceptual framework to design effective ATP strategy for secondary prevention patients.
Collapse
Affiliation(s)
- Daniel J Cantillon
- Cleveland Clinic, Heart and Vascular Institute, Cardiac Electrophysiology and Pacing, Cleveland, Ohio.
| | - Bruce L Wilkoff
- Cleveland Clinic, Heart and Vascular Institute, Cardiac Electrophysiology and Pacing, Cleveland, Ohio
| |
Collapse
|
17
|
Lundberg AB, Bowen KP, Baumgart PM, Caplan JP. Phantom Shocks and Automated Implantable Cardioverter Defibrillators. PSYCHOSOMATICS 2015; 56:94-7. [DOI: 10.1016/j.psym.2014.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 09/09/2014] [Accepted: 09/09/2014] [Indexed: 10/24/2022]
|
18
|
Verhagen MP, van Boven N, Ruiter JH, Kimman GJP, Tahapary GJ, Umans VA. Follow-up of implantable cardioverter-defibrillator therapy: comparison of coronary artery disease and dilated cardiomyopathy. Neth Heart J 2014; 22:431-7. [PMID: 25169578 PMCID: PMC4188850 DOI: 10.1007/s12471-014-0595-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Since several large trials have proven the effectiveness of implantable cardioverter-defibrillators (ICDs) in patients with left ventricular dysfunction, disadvantages have become more apparent. As the prognosis of patients with cardiovascular diseases is improving, assessment of ICD patients and re-evaluation of the current guidelines is mandatory. We aimed to evaluate differences in mortality and occurrence of (in)appropriate shocks in ICD patients with coronary artery disease (CAD) or dilated cardiomyopathy (DCM). METHODS In a large teaching hospital, all consecutive patients with systolic dysfunction due to CAD or DCM who received an ICD with and without resynchronisation therapy, were collected in a database. RESULTS A total of 320 consecutive patients (age 67 ± 10 years) were classified as CAD patients and 178 (63 ± 11 years) as DCM patients. Median follow-up was 40 months (interquartile range [IQR] 23─57 months). All-cause mortality was 14 % (CAD 15 % vs DCM 13 %). Appropriate shocks occurred in 13 % of all patients (CAD 15 % vs DCM 11 %, p = 0.12) and inappropriate shocks occurred in 10 % (CAD 8 % vs DCM 12 %, p = 0.27). Multivariate analysis demonstrated impaired left ventricular ejection fraction, QRS >120, age ≥75 years and low estimated glomerular filtration rate as predictors for all-cause mortality. Predictors for inappropriate shocks were permanent and paroxysmal atrial fibrillation. CONCLUSION Mortality rates were similar in patients with CAD and DCM who received an ICD. Furthermore, no differences were found in the occurrence of appropriate and inappropriate ICD interventions between these patient groups.
Collapse
Affiliation(s)
- M P Verhagen
- Department of Cardiology, Medical Centre Alkmaar (MCA), Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands
| | | | | | | | | | | |
Collapse
|
19
|
Mastenbroek MH, Pedersen SS, Versteeg H, Doevendans PA, Meine M. State of the art of ICD programming: Lessons learned and future directions. Neth Heart J 2014; 22:415-20. [PMID: 25074477 PMCID: PMC4188844 DOI: 10.1007/s12471-014-0582-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The lifesaving benefits of implantable cardioverter defibrillator (ICD) therapy are more and more weighted against possible harm (e.g. unnecessary device therapy, procedural complications, device malfunction etc.) which might have adverse effects on patients' perceived health status and quality of life. Hence, there has been an increasing interest in the optimisation of ICD programming to prevent inappropriate and appropriate but unnecessary device therapy. The purpose of the current report is to give an overview of research into the optimisation of ICD programming and present the design of the on-going ENHANCED-ICD study. The ENHANCED-ICD study is a prospective, safety monitoring study enrolling 60 primary and secondary prophylactic ICD patients at the University Medical Center Utrecht. Patients implanted with any type of ICD with SmartShock technology(TM), and between 18-80 years of age, were eligible to participate. In all patients a prolonged detection of 60/80 intervals was programmed. The primary objective of the study is to investigate whether enhanced programming to further reduce ICD therapies is safe. The secondary objective is to examine the impact of enhanced programming on (i) antitachycardia pacing and shocks (both appropriate and inappropriate) and (ii) quality of life and distress. The first results of the ENHANCED-ICD study are expected in 2015.
Collapse
Affiliation(s)
- M H Mastenbroek
- Cardiology, Department of Heart and Lung, University Medical Center, Heidelberglaan 100, PO Box 85500, 3584 CX, Utrecht, the Netherlands,
| | | | | | | | | |
Collapse
|
20
|
STARRENBURG ANNEMIEKE, KRAAIER KARIN, PEDERSEN SUSANNE, SCHOLTEN MARCOEN, VAN DER PALEN JOB. Psychological Indices as Predictors for Phantom Shocks in Implantable Cardioverter Defibrillator Recipients. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 37:768-73. [DOI: 10.1111/pace.12343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 11/13/2013] [Accepted: 11/26/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - KARIN KRAAIER
- Department of Cardiology; Thorax Center Twente; Medisch Spectrum Twente; Enschede the Netherlands
| | - SUSANNE PEDERSEN
- C o RPS-Center of Research on Psychology in Somatic diseases; Tilburg University; Tilburg the Netherlands
- Department of Cardiology; Thorax Center; Erasmus Medical Centre; Rotterdam the Netherlands
| | - MARCOEN SCHOLTEN
- Department of Cardiology; Thorax Center Twente; Medisch Spectrum Twente; Enschede the Netherlands
| | - JOB VAN DER PALEN
- Department of Research Methodology; Measurement and Data Analysis; University of Twente; Enschede the Netherlands
- Medical School Twente; Medisch Spectrum Twente; Enschede the Netherlands
| |
Collapse
|
21
|
Salles M, Amet D, Archer V, Elbaz N, Teiger E, Paul M, Astier A. Évaluation de l’appropriation d’un dispositif médical implantable par les patients. ANNALES PHARMACEUTIQUES FRANÇAISES 2013; 71:423-8. [DOI: 10.1016/j.pharma.2013.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/18/2013] [Accepted: 06/28/2013] [Indexed: 10/26/2022]
|
22
|
Pre-hospital discharge testing of defibrillator without anesthesia: effects on psychological symptoms during clinical follow-up. Psychosom Med 2013; 75:640-9. [PMID: 23975945 DOI: 10.1097/psy.0b013e31829a8c89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE After the implantation of an implantable cardioverter-defibrillator (ICD), patients often fear therapeutic shock. The extent to which the experience of pre-hospital discharge (PHD) testing without anesthesia after ICD implantation, under observation by a physician, affects shock-related anxiety symptoms on follow-up has not been investigated as yet. METHODS In a prospective, randomized controlled trial, 44 patients with a primary prevention indication for an ICD were randomly assigned to experience PHD testing without anesthesia (n = 23) or with anesthesia (n = 21). Patients were longitudinally evaluated before (T(1)), shortly after (T(2)), and 3 months after (T(3)) PHD testing. During the respective PHD testings, the course of patients' serum cortisol release was measured. RESULTS During PHD testing, patients without anesthesia showed a significantly higher serum cortisol release than patients with anesthesia (F(4,152) = 22.227, p < .001). Patients who experienced PHD testing without anesthesia felt significantly safer with the ICD (U = 165.000, p = .040), would significantly more often recommend other patients to undergo PHD testing without anesthesia (χ(2) = 12.013, p = .002), and showed significantly lower levels of general shock-related anxiety shortly afterward (F(1,42) = 6.327, p = .02) and 3 months after PHD testing (F(1,41) = 8.603, p = .005). CONCLUSIONS The implementation of PHD testing without anesthesia is associated with lower anxiety concerning therapeutic shock. Patients should be advised about the effects of PHD testing without anesthesia on their psychological well-being in the long run.
Collapse
|
23
|
Phantom shocks: innocent bystander or complication of implantable cardioverter defibrillator therapy? Neth Heart J 2013; 21:189-90. [DOI: 10.1007/s12471-013-0388-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|