1
|
Vicentini A, Bisignani G, De Vivo S, Viani S, Savarese G, Francia P, Celentano E, Checchi L, Carreras G, Santini L, Lamberti F, Ottaviano L, Scalone A, Giorgi D, Lovecchio M, Valsecchi S, Rordorf R. Patient acceptance of subcutaneous versus transvenous defibrillator systems: A multi-center experience. J Cardiovasc Electrophysiol 2021; 33:81-89. [PMID: 34797012 DOI: 10.1111/jce.15297] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an effective alternative to the transvenous ICD. No study has yet compared S-ICD and transvenous ICD by assessing patient acceptance as a patient-centered outcome. OBJECTIVE To evaluate the patient acceptance of the S-ICD and to investigate its association with clinical and implantation variables. In patients with symptomatic heart failure and reduced ejection fraction (HFrEF), the acceptance of the S-ICD was compared with a control group of patients who received a transvenous ICD. METHODS Patient acceptance was calculated with the Florida Patient Acceptance Survey (FPAS) which measures four factors: return to function (RTF), device-related distress (DRD), positive appraisal (PA), and body image concerns (BIC). The survey was administered 12 months after implantation. RESULTS 176 patients underwent S-ICD implantation. The total FPAS and the single factors did not differ according to gender, body habitus, or generator positioning. Patients with HFrEF had lower FPAS and RTF. Younger patients showed better RTF (75 [56-94] vs. 56 [50-81], p = .029). Patients who experienced device complications or device therapies showed higher DRD (40 [35-60] vs. 25 [10-50], p = .019). Patients with HFrEF receiving the S-ICD had comparable FPAS, RTF, DRD, and BIC to HFrEF patients implanted with the transvenous ICD while exhibited significantly better PA (88 [75-100] vs. 81 [63-94], p = .02). CONCLUSIONS Our analysis revealed positive patient acceptance of the S-ICD, even in groups at risk of more distress such as women or patients with thinner body habitus, and regardless of the generator positioning. Among patients receiving ICDs for HFrEF, S-ICD was associated with better PA versus transvenous ICD.
Collapse
Affiliation(s)
- Alessandro Vicentini
- Department of Arrhythmia and Electrophysiology and Experimental Cardiology, IRCCS Fondazione Policlinico 'S. Matteo', Pavia, Italy
| | | | - Stefano De Vivo
- Unità Operativa di Elettrofisiologia, 'Studio e Terapia delle Aritmie', Monaldi Hospital, Naples, Italy
| | - Stefano Viani
- Division of Second Cardiology, Department of Cardio-Thoracic and Vascular, University Hospital of Pisa, Pisa, Italy
| | - Gianluca Savarese
- Department of Cardiology, 'San Giovanni Battista' Hospital, Foligno, Italy
| | - Pietro Francia
- Cardiology, Department of Clinical and Molecular Medicine, 'St. Andrea' Hospital, Sapienza University, Rome, Italy
| | - Eduardo Celentano
- Department of Cardiology, 'Santa Maria della Pietà' Hospital, Casoria, Napoli, Italy
| | | | | | - Luca Santini
- Division of Cardiology, Divisiono of Hospital Cardiology, 'Giovan Battista Grassi' Hospital, Rome, Italy
| | - Filippo Lamberti
- Department of Medicine, Cardiovascular Section, 'San Eugenio' Hospital, Rome, Italy
| | - Luca Ottaviano
- Department of Cardiology, Istituto Clinico 'Sant'Ambrogio', Milan, Italy
| | | | - Davide Giorgi
- Division of Cardiology, 'San Luca' Hospital, Lucca, Italy
| | | | | | - Roberto Rordorf
- Department of Arrhythmia and Electrophysiology and Experimental Cardiology, IRCCS Fondazione Policlinico 'S. Matteo', Pavia, Italy
| | | |
Collapse
|
3
|
Lauck SB, Sawatzky R, Johnson JL, Humphries K, Bennett MT, Chakrabarti S, Kerr CR, Tung S, Yeung-Lai-Wah JA, Ratner PA. Sex Is Associated With Differences in Individual Trajectories of Change in Social Health After Implantable Cardioverter-Defibrillator. Circ Cardiovasc Qual Outcomes 2015; 8:S21-30. [DOI: 10.1161/circoutcomes.114.001607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Social health is a dimension of quality of life, and refers to people’s involvement in, and satisfaction with social roles, responsibilities, and activities. The implantable cardioverter-defibrillator is associated with changes in overall quality of life, but little is known about sex differences in individual trajectories of change in social health.
Methods and Results—
We prospectively measured changes in 3 subscales of the SF-36v2 generic health questionnaire (role physical, role emotional, and social functioning), 2 Patient-Reported Outcomes Measurement Information System short forms (satisfaction with participation in social roles and satisfaction with participation in discretionary social activities), and the Florida Patient Acceptance Survey before and at 1, 2, and 6 months after implantation. Individual growth models of temporal change were estimated. The scores of the 6 indicators improved with time. The unconditional model demonstrated significant (fixed effects:
P
<0.05; covariance parameters:
P
<0.10) residual variability in the individual trajectories. In the conditional model, men and women differed significantly in their rates of change in the scores of 3 of the 6 measures. Although men’s mean scores exceeded women’s mean scores on all indicators at baseline (range of relative mean difference: 11.0% to 17.8%), the rate of women’s change resulted in a reversal in relative standing at 6 months after implantation, with the mean scores of women exceeding the men’s by 4.5% to 5.6%.
Conclusions—
Men and women differed in their trajectories of change in social health, both in terms of their starting points (ie, baseline scores) and their rates of change.
Collapse
Affiliation(s)
- Sandra B. Lauck
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Richard Sawatzky
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Joy L. Johnson
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Karin Humphries
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Matthew T. Bennett
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Santabhanu Chakrabarti
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Charles R. Kerr
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Stanley Tung
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - John A. Yeung-Lai-Wah
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| | - Pamela A. Ratner
- From the University of British Columbia, Vancouver, Canada (S.B.L., J.L.J., K.H., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W., P.A.R.) and Trinity Western University, Langley, Canada (R.S.); Department of Cardiology and Cardiac Programs, St. Paul's Hospital and Vancouver General Hospital, Vancouver, BC, Canada (S.B.L., M.T.B., S.C., C.R.K., S.T., J.A.Y.L.W); and Providence Health Care, Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada (R.S.)
| |
Collapse
|