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Mornar Jelavić M, Krstačić G, Perenčević A, Pintarić H. Sexual Activity in Patients with Cardiac Diseases. Acta Clin Croat 2018; 57:141-148. [PMID: 30256023 PMCID: PMC6400344 DOI: 10.20471/acc.2018.57.01.18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
SUMMARY – In this article, we outline the latest guidelines published by the American Heart Association on sexual activity in patients with coronary artery disease, heart failure, structural heart diseases, arrhythmias, implanted pacemakers or cardioverter defibrillators, as well as on treatment options of sexual dysfunction. Sexual activities are similar to mild/moderate physical activity during a short period. Most patients are recommended to involve in sexual activity after prior comprehensive evaluation of physical condition. Those with stable cardiac symptoms and good functional capacity are at a low risk of adverse cardiovascular events, and others require treatment or stabilization before involving in sexual activity. Stress testing is useful in evaluating safety of sexual activity in patients with questionable or undetermined risk. Treatment of sexual dysfunction includes counseling of patients and their sexual partners, and drug treatment with phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil) which have been demonstrated to be safe and effective, in men, and with serotonin reuptake inhibitors (flibanserin) and local vaginal estrogen administration in women. In conclusion, in routine clinical practice, patients should be approached individually and multidisciplinarily in order to detect and eliminate the factors that interfere with normal sexual activities and disturb the quality of life.
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Affiliation(s)
| | - Goran Krstačić
- Institute for Cardiovascular Prevention and Rehabilitation, Zagreb, Croatia.,School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Aleksandra Perenčević
- Department of Internal Medicine and Dialysis, Zagreb-East Health Center, Zagreb, Croatia
| | - Hrvoje Pintarić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia.,Cardiac Catheterization Laboratory, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
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KIKKENBORG BERG SELINA, CASPAR THYGESEN LAU, HASTRUP SVENDSEN JESPER, VINGGAARD CHRISTENSEN ANNE, ZWISLER ANNDORTHE. Anxiety Predicts Mortality in ICD Patients: Results from the Cross-Sectional National CopenHeartICDSurvey with Register Follow-Up. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 37:1641-50. [DOI: 10.1111/pace.12490] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 06/23/2014] [Accepted: 07/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - LAU CASPAR THYGESEN
- National Institute of Public Health; University of Southern Denmark; Copenhagen Denmark
| | - JESPER HASTRUP SVENDSEN
- Heart Centre; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC); Copenhagen Denmark
- Department of Clinical Medicine; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | | | - ANN-DORTHE ZWISLER
- National Institute of Public Health; University of Southern Denmark; Copenhagen Denmark
- Department of Cardiology; Holbaek Hospital; Holbaek Denmark
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Levine GN, Steinke EE, Bakaeen FG, Bozkurt B, Cheitlin MD, Conti JB, Foster E, Jaarsma T, Kloner RA, Lange RA, Lindau ST, Maron BJ, Moser DK, Ohman EM, Seftel AD, Stewart WJ. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2012; 125:1058-72. [PMID: 22267844 DOI: 10.1161/cir.0b013e3182447787] [Citation(s) in RCA: 235] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Sears SF, Hauf JD, Kirian K, Hazelton G, Conti JB. Posttraumatic Stress and the Implantable Cardioverter-Defibrillator Patient. Circ Arrhythm Electrophysiol 2011; 4:242-50. [PMID: 21505176 DOI: 10.1161/circep.110.957670] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Samuel F. Sears
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Jessica D. Hauf
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Kari Kirian
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Garrett Hazelton
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Jamie B. Conti
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
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Dickerson SS, Kennedy M, Wu YWB, Underhill M, Othman A. Factors related to quality-of-life pattern changes in recipients of implantable defibrillators. Heart Lung 2010; 39:466-76. [DOI: 10.1016/j.hrtlng.2009.10.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 09/24/2009] [Accepted: 10/30/2009] [Indexed: 11/28/2022]
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Mishkin JD, Saxonhouse SJ, Woo GW, Burkart TA, Miles WM, Conti JB, Schofield RS, Sears SF, Aranda JM. Appropriate Evaluation and Treatment of Heart Failure Patients After Implantable Cardioverter-Defibrillator Discharge. J Am Coll Cardiol 2009; 54:1993-2000. [DOI: 10.1016/j.jacc.2009.07.039] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 06/25/2009] [Accepted: 07/12/2009] [Indexed: 11/25/2022]
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SERBER EVAR, FINCH NANCYJ, LEMAN ROBERTB, STURDIVANT LACYJ, BARNES TAMMY, CLARKE ELIZABETH, GARRY JENNIFER, GOLD MICHAELR. Disparities in Preferences for Receiving Support and Education Among Patients with Implantable Cardioverter Defibrillators. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2009; 32:383-90. [DOI: 10.1111/j.1540-8159.2008.02248.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Smeulders ESTF, van Haastregt JCM, Dijkman-Domanska BK, van Hoef EFM, van Eijk JT, Kempen GIJM. Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study. BMC Nurs 2007; 6:6. [PMID: 17880674 PMCID: PMC2096621 DOI: 10.1186/1472-6955-6-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 09/19/2007] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD) experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP) among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years) participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life) were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a team consisting of a nurse specialist and a patient with cardiovascular disease seems feasible according to both patients and leaders. The programme may improve general self-efficacy expectancies, symptoms of anxiety, and quality of life (physical functioning, social functioning, role limitations due to physical problems, and pain) as well. Further investigation of the programme's effectiveness among a larger sample of ICD patients or other patient groups with cardiovascular disease, is recommended.
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Affiliation(s)
- Esther STF Smeulders
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jolanda CM van Haastregt
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Barbara K Dijkman-Domanska
- University Hospital Maastricht, Department of Cardiology, PO Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Elisabeth FM van Hoef
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jacques ThM van Eijk
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Gertrudis IJM Kempen
- Maastricht University, Faculty of Health, Medicine and Life sciences, School for Public Health and Primary Care, PO Box 616, 6200 MD Maastricht, The Netherlands
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Aranda JM, Woo GW, Schofield RS, Handberg EM, Hill JA, Curtis AB, Sears SF, Goff JS, Pauly DF, Conti JB. Management of Heart Failure After Cardiac Resynchronization Therapy. J Am Coll Cardiol 2005; 46:2193-8. [PMID: 16360045 DOI: 10.1016/j.jacc.2005.03.078] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2004] [Revised: 02/23/2005] [Accepted: 03/10/2005] [Indexed: 11/28/2022]
Abstract
Cardiac resynchronization therapy (CRT) is an established adjunctive treatment for patients with systolic heart failure (HF) and ventricular dyssynchrony. The majority of recipients respond to CRT with improvements in quality of life, New York Heart Association functional class, 6-min walk test, and ventricular function. Management of HF after CRT may include up-titration of neurohormonal blockade and an exercise prescription through cardiac rehabilitation to further improve and sustain clinical outcomes. Diagnostic data provided by the CRT device may help to facilitate and optimize treatment. Initial nonresponder rates remain problematic. We suggest a simple step-by-step management and troubleshooting strategy that integrates device function with advanced HF therapy in patients who do not initially respond to CRT. This algorithm represents a new, comprehensive, collaborative approach between the HF and electrophysiology specialists to further improve and sustain outcomes in the field of CRT.
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Affiliation(s)
- Juan M Aranda
- Division of Cardiovascular Medicine, College of Medicine, University of Florida Health Science Center, Gainesville, Florida, USA.
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Davids JS, McPherson CA, Earley C, Batsford WP, Lampert R. Benefits of cardiac rehabilitation in patients with implantable cardioverter-defibrillators: a patient survey. Arch Phys Med Rehabil 2005; 86:1924-8. [PMID: 16213232 DOI: 10.1016/j.apmr.2005.04.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Revised: 03/14/2005] [Accepted: 04/04/2005] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To determine whether participation in an outpatient cardiac rehabilitation (OCR) program increases exercise levels and decreases shocks in patients with implantable cardioverter-defibrillators (ICDs). DESIGN Retrospective comparative survey. SETTING University tertiary-care ICD clinic. PARTICIPANTS Patients with ICDs and coronary artery disease. INTERVENTION Participation in OCR (nonrandomized). MAIN OUTCOME MEASURES Exercise levels and OCR participation were determined through a telephone survey of patients with ICDs. The incidence of shock-treated arrhythmia was determined by review of charts and ICD data storage disks. RESULTS Of 82 patients (85% men; mean age, 61+/-8 y), 28 (34%) participated in OCR after receiving an ICD. There was no difference in age, sex, ejection fraction, or length of follow-up between OCR and non-OCR groups. Median intensity of regular exercise was 5.3 metabolic equivalents (METS) for OCR patients versus 3.5 METS for non-OCR patients (P<.02). In follow-up (mean, 48+/-3 mo), non-OCR patients were more likely to receive any shock, shocks during exercise, or shocks for ventricular arrhythmia during exercise than OCR patients (all P<.05). Non-OCR remained a predictor of shock after adjustment for exercise limitation (P<.05). CONCLUSIONS OCR patients exercised more and had fewer shocks. Physicians and health plans should encourage ICD patients to participate in OCR.
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Affiliation(s)
- Jennifer S Davids
- Section of Cardiovascular Medicine, Yale University Medical School, New Haven, CT 06520, USA
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