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Dörner M, von Känel R, König N, Pazhenkottil AP, Altwegg R, Nager L, Attanasio V, Guth L, Zirngast S, Menzi A, Zuccarella-Hackl C, Princip M. Mindfulness Is Associated with Lower Depression, Anxiety, and Post-Traumatic Stress Disorder Symptoms and Higher Quality of Life in Patients with an Implantable Cardioverter-Defibrillator-A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1118. [PMID: 38891193 PMCID: PMC11172204 DOI: 10.3390/healthcare12111118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Several studies suggested the efficacy of dispositional mindfulness and mindfulness-based interventions in reducing anxiety and depression in cardiovascular diseases. However, data on the impact of mindfulness on the psychological well-being of patients with an implantable cardioverter-defibrillator (ICD) are scarce. In this study, 422 patients with an ICD were prospectively recruited. Logistic regression was applied to determine associations between dispositional mindfulness (Freiburg Mindfulness Inventory), depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7 scale), and post-traumatic stress disorder (PTSD) symptoms (Post-Traumatic Stress Diagnostic Scale), adjusting for age, sex, educational status, number of ICD shocks after ICD implantation, and physical activity. The PROCESS regression path analysis modelling tool was used to identify indirect mediating effects of dispositional mindfulness on depression, anxiety, and PTSD symptoms and quality of life (QoL; EuroQol group 5-dimension questionnaire). Participants presented high baseline QoL (mean 1.06 to 1.72) and medium-high mindfulness scores (mean 40.85 points). Higher mindfulness scores were associated with lower levels of anxiety (OR 0.90, 95% CI 0.86 to 0.95, 0.001), depression (OR 0.93, 95% CI 0.88 to 0.98, p = 0.006), and PTSD symptoms (OR 0.94, 95% CI 0.89 to 0.98, p = 0.011). Furthermore, greater mindfulness partially mediated the relationship between anxiety (indirect effect 0.10, 95% CI 0.02 to 0.21), depression (indirect effect 0.08, 95% CI 0.01 to 0.17), or PTSD (indirect effect 0.04, 95% CI 0.01 to 0.17) as independent variables and the QoL as the dependent variable. This study suggests that greater dispositional mindfulness is associated with less anxiety, depression, and PTSD symptoms. Mindfulness might also increase the QoL in ICD patients by mitigating the impact of those with psychological distress.
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Affiliation(s)
- Marc Dörner
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
- German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, 39120 Magdeburg, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Noelle König
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Aju P. Pazhenkottil
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Rahel Altwegg
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Ladina Nager
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Veronica Attanasio
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Lisa Guth
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Sina Zirngast
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Anna Menzi
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
| | - Mary Princip
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (N.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (A.M.); (C.Z.-H.); (M.P.)
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Tan RB, Stephenson EA, Bulic A. Epicardial Devices in Pediatrics and Congenital Heart Disease. Card Electrophysiol Clin 2023; 15:467-480. [PMID: 37865520 DOI: 10.1016/j.ccep.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Epicardial cardiac implantable electronic device implant remains a common option in pediatric patients and certain patients with congenital heart disease due to patient size, complex anatomy, residual intracardiac shunts, and prior surgery precluding transvenous implant. Advantages include the lack of thromboembolic and vascular risks and ability to implant during concomitant surgery. Significant disadvantages include the occurrence of lead dysfunction that can result in bradycardia events in pacemaker patients, inappropriate shocks in implantable cardiac defibrillator patients, and overall a more invasive procedure.
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Affiliation(s)
- Reina Bianca Tan
- Division of Cardiology, Department of Pediatrics, NYU Langone Health and Hassenfeld Children's Hospital, 403 East 34th Street, Level 4, New York, NY 10017, USA.
| | - Elizabeth A Stephenson
- University of Toronto, The Hospital for Sick Children, Labatt Family Heart Centre, 555 University Avenue, Room 1725, Toronto, Ontario M5G1X8, Canada
| | - Anica Bulic
- University of Toronto, The Hospital for Sick Children, Labatt Family Heart Centre, 555 University Avenue, Room 1725, Toronto, Ontario M5G1X8, Canada
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Dörner M, von Känel R, Pazhenkottil AP, Altwegg R, Nager L, Attanasio V, Guth L, Zirngast S, Menzi A, Princip M, Hackl-Zuccarella C. Fear of COVID-19 Predicts Depression, Anxiety and Post-Traumatic Stress Disorders in Patients with Implantable Cardioverter Defibrillators and Is Mediated by Positive and Negative Affects-A Cross-Sectional Study. J Clin Med 2023; 12:6884. [PMID: 37959349 PMCID: PMC10648893 DOI: 10.3390/jcm12216884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The COVID-19 pandemic affected both the physical and mental health of the general population. People with cardiac diseases seem to be particularly vulnerable to the implications of the pandemic. However, studies on the mental health impact of the COVID-19 pandemic on people with implantable cardioverter defibrillator (ICDs) are lacking. Thus, we aimed to explore the level of fear of COVID-19 and the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in ICD patients. Furthermore, we aimed to identify novel predictors for anxiety, depression and PTSD, including COVID-19-related variables, and to assess whether positive affects (PAs) and negative affects (NAs) mediate the relationship between the level of fear of COVID-19 and anxiety, depression and PTSD, respectively. The data of 363 patients with ICDS who had been prospectively included in this study between 2020 and 2023, were analyzed. Potential predictors for anxiety, depression, and PTSD were identified using logistic regression. To identify indirect mediating effects of PAs and NAs, we applied the PROCESS regression path analysis modeling tool. The prevalence of anxiety was 9.19%, of depression 10.85%, and of PTSD 12.99%. Being unemployed was the strongest predictor for anxiety (OR = 10.39) and depression (OR = 6.54). Younger age predicted anxiety (OR = 0.95) and PTSD (OR = 0.92). Receiving low social support was associated with anxiety (OR = 0.91), depression (OR = 0.88) and PTSD (OR = 0.91). Patients with a history of COVID-19 (OR = 3.58) and those who did not feel well-informed about COVID-19 (OR = 0.29) were more likely to be depressed. Higher levels of fear of COVID-19 predicted anxiety (OR = 1.10), depression (OR = 1.12) and PTSD (OR = 1.14). The relationship between fear of COVID-19 and anxiety or depression was fully mediated by PAs and NAs, while NAs partially mediated the relationship between fear of COVID-19 and PTSD. Vulnerable subgroups of ICD patients may need additional psychological and educational interventions due to fear of COVID-19, anxiety, depression and PTSD during the pandemic.
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Affiliation(s)
- Marc Dörner
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
- German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, 39120 Magdeburg, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Aju P. Pazhenkottil
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Rahel Altwegg
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Ladina Nager
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Veronica Attanasio
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Lisa Guth
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Sina Zirngast
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Anna Menzi
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Mary Princip
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
| | - Claudia Hackl-Zuccarella
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (R.v.K.); (A.P.P.); (R.A.); (L.N.); (V.A.); (L.G.); (S.Z.); (M.P.); (C.H.-Z.)
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Wells A, Heal C, Reeves D, Capobianco L. Prevalence of post-traumatic stress and tests of metacognition as a PTSD risk marker in patients with coronary heart disease and elevated HADS scores: analysis of data from the PATHWAY RCT's in UK cardiac rehabilitation. Front Psychiatry 2023; 14:1198202. [PMID: 37484675 PMCID: PMC10357285 DOI: 10.3389/fpsyt.2023.1198202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Anxiety and depression in coronary heart disease (CHD) are associated with poorer health outcomes, greater healthcare use and reduced quality of life. Post-traumatic stress symptoms may be a particular concern as they are associated with increased mortality at follow-up. We examined prevalence of PTSD in patients with elevated anxiety/depression scores referred for cardiac rehabilitation (CR) across seven NHS sites in North-West England. We tested a possible mechanism (metacognition) linking CHD to PTSD symptom severity as implicated in the metacognitive model. Methods Data was collected at baseline as part of the NIHR funded PATHWAY trial of metacognitive therapy for anxiety and depression in CHD. Patients (n = 572) with at least mild symptoms of anxiety and depression under routine screening (assessed with the Hospital Anxiety and Depression Scale) and attending CR were eligible for the study. A battery of questionnaires, including assessment of demographic variables, PTSD symptoms (using the IES-R) and metacognitive beliefs was administered prior to random allocation and intervention delivery. Results Rates of PTSD were high, with 48% of patients meeting threshold for PTSD and a further 15% partial PTSD. All five metacognition subscales were positively associated with PTSD vs. no PTSD, with beliefs about the uncontrollability and danger of worry and beliefs about need to control thoughts being most strongly related. For every unit increase in uncontrollability and danger metacognitions the odds of being in the PTSD group increased 30%, whilst the odds of partial PTSD increased 16%. Stepwise regression analysis using the metacognitive subscales along with demographic and health-related covariates found that uncontrollability/danger and need for control metacognitions explained unique variation in PTSD symptom severity, with unique contributions also for age, sex, and number of comorbidities. Conclusion PTSD symptoms appeared highly prevalent in the current CR sample. Metacognitive beliefs were individually associated with symptom severity with the strongest positive relationship observed for beliefs about uncontrollability and dangerousness of worry, followed by need to control thoughts. The results highlight the importance in assessing PTSD in CR patients and add support to implementing metacognitive therapy in CHD to target particular metacognition risk factors in anxiety, depression and PTSD.
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Affiliation(s)
- Adrian Wells
- Division of Psychology and Mental Health, School of Psychological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Research and Innovation, Greater Manchester Mental Health NHS Trust, Manchester, United Kingdom
| | - Calvin Heal
- Centre for Biostatistics, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - David Reeves
- Centre for Biostatistics, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- NIHR School for Primary Care Research, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Lora Capobianco
- Research and Innovation, Greater Manchester Mental Health NHS Trust, Manchester, United Kingdom
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Yusufov M, Pirl WF, Braun I, Tulsky JA, Lindvall C. Natural Language Processing for Computer-Assisted Chart Review to Assess Documentation of Substance use and Psychopathology in Heart Failure Patients Awaiting Cardiac Resynchronization Therapy. J Pain Symptom Manage 2022; 64:400-409. [PMID: 35716959 DOI: 10.1016/j.jpainsymman.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Advanced heart failure (HF) patients often experience distressing psychological symptoms, frequently meeting diagnostic criteria for psychological disorders, including anxiety, depression, and substance use disorder. Patients with device-based HF therapies have added risk for psychological disorders, with consequences for their physiological functioning, including adverse cardiac outcomes. OBJECTIVES This study used natural language processing (NLP) for computer-assisted chart review to assess documentation of mental health and substance use in HF patients awaiting cardiac resynchronization therapy (CRT), a device-based HF therapy. METHODS We applied NLP to clinical notes from electronic health records (EHR) of 965 consecutive patients, with 9821 total clinical notes, at two academic medical centers between 2004 and 2015. We developed and validated a keyword library capturing terms related to mental health and substance use, while balancing specificity and sensitivity. RESULTS Mean age was 71.6 years (SD = 11.8), 78% male, and 87% non-Hispanic White. Of the 544 patients (56.4%) with documentation of mental health history, 9.7% had their mental health assessed and 6.6% had a plan documented. Of the 773 patients (80.1%) with documentation of substance use history, 10 (1.0%) had an assessment, and 3 (0.3%) had a plan. CONCLUSION Despite clinical recommendations and standards of care, clinicians are under documenting assessments and plans prior to CRT. Future research should develop an algorithm to prompt clinicians to document this content. Such quality improvement efforts may ensure adherence to standards of care and clinical guidelines.
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Affiliation(s)
- Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care (M.Y., W.F.P., I.B., J.A.T., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School (M.Y., W.F.P., I.B., J.A.T., C.L.), Boston, Massachusetts, USA.
| | - William F Pirl
- Department of Psychosocial Oncology and Palliative Care (M.Y., W.F.P., I.B., J.A.T., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School (M.Y., W.F.P., I.B., J.A.T., C.L.), Boston, Massachusetts, USA
| | - Ilana Braun
- Department of Psychosocial Oncology and Palliative Care (M.Y., W.F.P., I.B., J.A.T., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School (M.Y., W.F.P., I.B., J.A.T., C.L.), Boston, Massachusetts, USA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care (M.Y., W.F.P., I.B., J.A.T., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School (M.Y., W.F.P., I.B., J.A.T., C.L.), Boston, Massachusetts, USA
| | - Charlotta Lindvall
- Department of Psychosocial Oncology and Palliative Care (M.Y., W.F.P., I.B., J.A.T., C.L.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School (M.Y., W.F.P., I.B., J.A.T., C.L.), Boston, Massachusetts, USA
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Lindekilde N, Skov O, Skovbakke SJ, Johansen JB, Nielsen JC, Pedersen SS. Anxiety and depression as risk factors for ICD shocks and mortality in patients with an implantable cardioverter defibrillator - A systematic review. Gen Hosp Psychiatry 2022; 78:96-107. [PMID: 35933929 DOI: 10.1016/j.genhosppsych.2022.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine associations between baseline anxiety and depression and occurrence of ICD shocks and risk of mortality in patients with an implantable cardioverter defibrillator (ICD). METHOD We systematically searched EMBASE, PubMed, PsycINFO, and CINAHL for eligible studies fulfilling the predefined criteria. RESULTS We included 37 studies based on 25 different cohorts following 35,003 participants for up to seven years. We observed no association between baseline anxiety nor depression and the occurrence of ICD shocks. More than half of the identified studies (respectively 56% and 60%) indicated a significant association between baseline anxiety or depression and increased risk of mortality (anxiety: n = 5, ranging from Hazard ratios (HR):1.02 [Confidence intervals (CI) 95% 1.00-1.03] to HR:3.45 [CI 95% 1.57-7.60]; depression: n = 6, ranging from HR:1.03 [CI 95% 1.00-1.06] to HR:2.10 [CI 95% 1.44-3.05]). We found a significant association between high methodological quality of the primary study and the detection of a significant association (p < 0.01). CONCLUSIONS Baseline anxiety and depression are associated with increased risk of mortality in patients with an ICD, but not with occurrence of ICD shocks. Inclusion of baseline anxiety and depression in risk stratification of mortality may be warranted.
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Affiliation(s)
- Nanna Lindekilde
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Ole Skov
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Søren J Skovbakke
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Jens B Johansen
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark
| | - Jens C Nielsen
- Department of Cardiology, Aarhus University Hospital, Brendstrupgårdsvej, 8200 Aarhus, Denmark & Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark
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Schneider LM, Wong JJ, Adams R, Bates B, Chen S, Ceresnak SR, Danovsky M, Hanisch D, Motonaga KS, Restrepo M, Shaw RJ, Sears SF, Trela A, Dubin AM, Hood KK. Post-Traumatic Stress Disorder in pediatric Implantable Cardioverter Defibrillator patients and their parents. Heart Rhythm 2022; 19:1524-1529. [DOI: 10.1016/j.hrthm.2022.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
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van den Heuvel LM, Sarina T, Sweeting J, Yeates L, Bates K, Spinks C, O’Donnell C, Sears SF, McGeechan K, Semsarian C, Ingles J. A Prospective Longitudinal Study of Health-Related Quality of Life and Psychological Wellbeing after an Implantable Cardioverter Defibrillator in Patients with Genetic Heart Diseases. Heart Rhythm O2 2022; 3:143-151. [PMID: 35496461 PMCID: PMC9043389 DOI: 10.1016/j.hroo.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Genetic heart diseases (GHDs) can be clinically heterogeneous and pose an increased risk of sudden cardiac death (SCD). The implantable cardioverter-defibrillator (ICD) is a lifesaving therapy. Impacts on prospective and long-term psychological and health-related quality of life (HR-QoL) after ICD implant in patients with GHDs are unknown. Objectives Investigate the psychological functioning and HR-QoL over time in patients with GHDs who receive an ICD, and identify risk factors for poor psychological functioning and HR-QoL. Methods A longitudinal, prospective study design was used. Patients attending a specialized clinic, diagnosed with a GHD for which they received an ICD between May 2012 and January 2015, were eligible. Baseline surveys were completed prior to ICD implantation with 5-year follow-up after ICD implant. We measured psychological functioning (Hospital Anxiety Depression Scale, Florida Shock Anxiety Scale), HR-QoL (Short-Form 36v2), and device acceptance (Florida Patient Acceptance Scale). Results Forty patients were included (mean age 46.3 ± 14.2 years; 65.0% male). Mean psychological and HR-QoL measures were within normative ranges during follow-up. After 12 months, 33.3% and 19.4% of participants showed clinically elevated levels of anxiety and depression, respectively. Longitudinal mixed-effect analysis showed significant improvements from baseline to first follow-up for the overall cohort, with variability increasing after 36 months. Nontertiary education and female sex predicted worse mental HR-QoL and anxiety over time, while comorbidities predicted depression and worse physical HR-QoL. Conclusion While the majority of patients with a GHD adjust well to their ICD implant, a subset of patients experience poor psychological and HR-QoL outcomes.
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Cyr S, Guo DX, Marcil MJ, Dupont P, Jobidon L, Benrimoh D, Guertin MC, Brouillette J. Posttraumatic stress disorder prevalence in medical populations: A systematic review and meta-analysis. Gen Hosp Psychiatry 2021; 69:81-93. [PMID: 33582645 DOI: 10.1016/j.genhosppsych.2021.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE PTSD is increasingly recognized following medical traumas although is highly heterogeneous. It is difficult to judge which medical contexts have the most traumatic potential and where to concentrate further research and clinical attention for prevention, early detection and treatment. The objective of this study was to compare PTSD prevalence in different medical populations. METHODS A systematic review of the literature on PTSD following medical traumas was conducted as well as a meta-analysis with final pooled result and 95% confidence intervals presented. A meta-regression was used to investigate the impact of potential effect modifiers (PTSD severity, age, sex, timeline) on study effect size between prevalence studies. RESULTS From 3278 abstracts, the authors extracted 292 studies reporting prevalence. Using clinician-administered reports, the highest 24 month or longer PTSD prevalence was found for intraoperative awareness (18.5% [95% CI=5.1%-36.6%]) and the lowest was found for epilepsy (4.5% [95% CI=0.2%-12.6%]). In the overall effect of the meta-regression, only medical events or procedures emerged as significant (p = 0.006) CONCLUSION: This review provides clinicians with greater awareness of medical contexts most associated with PTSD, which may assist them in the decision to engage in more frequent, earlier screening and referral to mental health services.
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Affiliation(s)
- Samuel Cyr
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada
| | - De Xuan Guo
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Marie-Joëlle Marcil
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Patrice Dupont
- Health Sciences Library, Université de Montréal, Montreal, Quebec, Canada
| | - Laurence Jobidon
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Center, Montreal, Montreal, Quebec, Canada
| | - Judith Brouillette
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
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10
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Leppert F, Siebermair J, Wesemann U, Martens E, Sattler SM, Scholz S, Veith S, Greiner W, Rassaf T, Kääb S, Wakili R. The INFluence of Remote monitoring on Anxiety/depRession, quality of lifE, and Device acceptance in ICD patients: a prospective, randomized, controlled, single-center trial. Clin Res Cardiol 2020; 110:789-800. [PMID: 32417952 PMCID: PMC8166667 DOI: 10.1007/s00392-020-01667-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/07/2020] [Indexed: 11/27/2022]
Abstract
Background Impact of telemedicine with remote patient monitoring (RPM) in implantable cardioverter–defibrillator (ICD) patients on clinical outcomes has been investigated in various clinical settings with divergent results. However, role of RPM on patient-reported-outcomes (PRO) is unclear. The INFRARED-ICD trial aimed to investigate the effect of RPM in addition to standard-of-care on PRO in a mixed ICD patient cohort. Methods and results Patients were randomized to RPM (n = 92) or standard in-office-FU (n = 88) serving as control group (CTL). At baseline and on a monthly basis over 1 year, study participants completed the EQ-5D questionnaire for the primary outcome Quality of Life (QoL), the Hospital Anxiety and Depression Scale, and the Florida Patient Acceptance Survey questionnaire for secondary outcomes. Demographic characteristics (82% men, mean age 62.3 years) and PRO at baseline were not different between RPM and CTL. Primary outcome analysis showed that additional RPM was not superior to CTL with respect to QoL over 12 months [+ 1.2 vs. + 3.9 points in CTL and RPM group, respectively (p = 0.24)]. Pre-specified analyses could not identify subgroups with improved QoL by the use of RPM. Neither levels of anxiety (− 0.4 vs. − 0.3, p = 0.88), depression (+ 0.3 vs. ± 0.0, p = 0.38), nor device acceptance (+ 1.1 vs. + 1.6, p = 0.20) were influenced by additional use of RPM. Conclusion The results of the present study show that PRO were not improved by RPM in addition to standard-of-care FU. Careful evaluation and planning of future trials in selected ICD patients are warranted before implementing RPM in routine practice. Graphic abstract ![]()
Electronic supplementary material The online version of this article (10.1007/s00392-020-01667-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florian Leppert
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Johannes Siebermair
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany.,Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Essen Medical School, University Duisburg-Essen, Essen, Germany.,Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Ulrich Wesemann
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital, Berlin, Germany
| | - Eimo Martens
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany.,Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefan M Sattler
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany.,Department of Cardiology, Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stefan Scholz
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Stefan Veith
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany
| | - Wolfgang Greiner
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Essen Medical School, University Duisburg-Essen, Essen, Germany
| | - Stefan Kääb
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany.,Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Reza Wakili
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany. .,Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University of Essen Medical School, University Duisburg-Essen, Essen, Germany. .,Deutsches Zentrum für Herz-Kreislauferkrankungen (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.
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11
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Sears SF, Ford J. Seeking innovation in the delivery of psychosocial care for ICD patients. Eur Heart J 2020; 41:1212-1214. [PMID: 30957866 DOI: 10.1093/eurheartj/ehz167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Samuel F Sears
- Departments of Psychology and Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
| | - Jessica Ford
- Departments of Psychology and Cardiovascular Sciences, East Carolina University, Greenville, NC, USA
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12
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Berg SK, Herning M, Thygesen LC, Cromhout PF, Wagner MK, Nielsen KM, Christensen AV, Rasmussen TB. Do patients with ICD who report anxiety symptoms on Hospital Anxiety and Depression Scale suffer from anxiety? J Psychosom Res 2019; 121:100-104. [PMID: 30955912 DOI: 10.1016/j.jpsychores.2019.03.183] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/26/2019] [Accepted: 03/28/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objectives were to determine: 1) whether patients with an implantable cardioverter defibrillator (ICD) presenting with anxiety symptoms measured on the Hospital Anxiety and Depression Scale (HADS) have identifiable anxiety according to the Structured Clinical Interview for DSM disorders (SCID) and 2) the type of anxiety, if any, behind a HADS-A score ≥ 8 in patients with an ICD. METHODS Patients with an ICD were screened using HADS and patients with a HADS-A score ≥ 8 were invited to participate. A total of 88 patients were included in the study and were interviewed using the SCID instrument to determine anxiety or adjustment disorder. RESULTS A total of 56% met the criteria for an anxiety diagnosis, 20% for adjustment disorder with anxiety and 8% for adjustment disorder without anxiety. Frequent types of anxiety were panic disorder, generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). Furthermore, 24 (28%) had an adjustment disorder. CONCLUSION A total of 84% meet the criteria for anxiety or adjustment disorder. The most common anxiety diagnoses were panic disorder, GAD and PTSD.
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Affiliation(s)
- Selina Kikkenborg Berg
- Department of Cardiology, Rigshospitalet, Copenhagen University, Hospital Blegdamsvej 9, 2100 Copenhagen, Denmark; National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | - Margrethe Herning
- Department of Cardiology, Herlev and Gentofte University Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Pernille Fevejle Cromhout
- Department of Cardiothoracic Anaesthesiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Mette Kirstine Wagner
- Department of Cardiology, Rigshospitalet, Copenhagen University, Hospital Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kim Mechta Nielsen
- Department of Cardiology, Rigshospitalet, Copenhagen University, Hospital Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Anne Vinggaard Christensen
- Department of Cardiology, Rigshospitalet, Copenhagen University, Hospital Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Trine Bernholdt Rasmussen
- Department of Cardiology, Herlev and Gentofte University Hospital, Niels Andersens Vej 65, 2900 Hellerup, Denmark
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13
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Ford J, Littleton H, Lutes L, Wuensch K, Benton C, Cahill J, Hudson C, Nekkanti R, Gehi A, Sears S. Evaluation of an Internet‐based intervention for ICD patients with elevated symptoms of posttraumatic stress disorder. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 42:521-529. [DOI: 10.1111/pace.13654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/08/2019] [Accepted: 03/02/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Jessica Ford
- Department of PsychologyEast Carolina University Greenville North Carolina
| | - Heather Littleton
- Department of PsychologyEast Carolina University Greenville North Carolina
| | - Lesley Lutes
- Department of PsychologyUniversity of British Columbia Kelowna BC Canada
| | - Karl Wuensch
- Department of PsychologyEast Carolina University Greenville North Carolina
| | - Christie Benton
- Department of Cardiovascular SciencesEast Carolina University, East Carolina Heart Institute Greenville North Carolina
| | - John Cahill
- Department of Cardiovascular SciencesEast Carolina University, East Carolina Heart Institute Greenville North Carolina
| | | | | | - Anil Gehi
- Department of MedicineUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Samuel Sears
- Department of PsychologyEast Carolina University Greenville North Carolina
- Department of Cardiovascular SciencesEast Carolina University, East Carolina Heart Institute Greenville North Carolina
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14
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Ofman P, Hoffmeister P, Kaloupek DG, Gagnon DR, Peralta A, Djousse L, Gaziano JM, Rahilly-Tierney CR. Posttraumatic stress disorder and mortality in VA patients with implantable cardioverter-defibrillators. Clin Cardiol 2018. [PMID: 29532498 DOI: 10.1002/clc.22945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The association between posttraumatic stress disorder (PTSD) and mortality in patients undergoing implantable cardioverter-defibrillator (ICD) placement has not been evaluated in US veterans. HYPOTHESIS PTSD in veterans with ICD is associated with increased mortality. METHODS We studied a retrospective cohort of 25 678 veterans who underwent ICD implantation between September 30, 2002, and December 31, 2011. Of these subjects, 3280 carried the diagnosis of PTSD prior to ICD implantation. Primary outcome was all-cause mortality between date of ICD implantation and end of follow-up (September 30, 2013). We used Cox proportional hazard models to compute multivariable adjusted hazard ratios with corresponding 95% confidence intervals for the relation between PTSD diagnosis and death following ICD placement. RESULTS During a mean follow-up of 4.21 ± 2.62 years, 11 015 deaths were reported. The crude incidence rate of death was 87.8 and 103.9/1000 person-years for people with and without PTSD, respectively. We did not find an association between presence of PTSD before or after ICD implantation and incident death when adjusted for multiple risk factors (hazard ratio: 1.003, 95% confidence interval: 0.948-1.061). In secondary analysis, no statistically significant association was found. CONCLUSIONS In this retrospective cohort study among more than 25 000 veterans undergoing ICD implantation, almost 13% had a diagnosis of PTSD. Subjects with PTSD were significantly younger, yet they had a higher incidence of coronary heart disease, major cardiac comorbidities, cancer, and mental health conditions. We found no association between presence of PTSD before or after ICD implantation and incident death when adjusting for all covariates.
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Affiliation(s)
- Peter Ofman
- Division of Cardiology, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts.,Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts.,Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter Hoffmeister
- Division of Cardiology, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
| | - Danny G Kaloupek
- National Center for Posttraumatic Stress Disorders, VA Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts
| | - David R Gagnon
- Division of Psychology, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts.,Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Adelqui Peralta
- Division of Cardiology, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts
| | - Luc Djousse
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts.,Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts
| | - J Michael Gaziano
- Division of Cardiology, VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts.,Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts.,Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts.,Division of Cardiology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Catherine R Rahilly-Tierney
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts
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15
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Schleifer JW, Shen WK. Implantable Cardioverter-Defibrillator Implantation, Continuation, and Deactivation in Elderly Patients. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0226-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Peregrinova L, Hamann B. Eye Movement Desensitization and Reprocessing im psychokardiologischen Setting. PSYCHOTHERAPEUT 2017. [DOI: 10.1007/s00278-017-0239-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Amiaz R, Asher E, Rozen G, Czerniak E, Levi L, Weiser M, Glikson M. Reduction in depressive symptoms in primary prevention ICD scheduled patients - One year prospective study. Gen Hosp Psychiatry 2017; 48:37-41. [PMID: 28917393 DOI: 10.1016/j.genhosppsych.2017.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/16/2017] [Accepted: 06/29/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Implantable Cardioverter Defibrillators (ICDs), have previously been associated with the onset of depression and anxiety. The aim of this one-year prospective study was to evaluate the rate of new onset psychopathological symptoms after elective ICD implantation. METHODS A total of 158 consecutive outpatients who were scheduled for an elective ICD implantation were diagnosed and screened based on the Mini International Neuropsychiatric Interview (MINI). Depression and anxiety were evaluated using the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A). Patient's attitude toward the ICD device was evaluated using a Visual Analog Scale (VAS). RESULTS Patients' mean age was 64±12.4years; 134 (85%) were men, with the majority of patients performing the procedure for reasons of 'primary prevention'. According to the MINI diagnosis at baseline, three (2%) patients suffered from major depressive disorder and ten (6%) from dysthymia. Significant improvement in HAM-D mean scores was found between baseline, three months and one year after implantation (6.50±6.4; 4.10±5.3 and 2.7±4.6, respectively F(2100)=16.42; p<0.001). There was a significantly more positive attitude toward the device over time based on the VAS score [F(2122)=53.31, p<0.001]. CONCLUSIONS ICD implantation significantly contributes to the reduction of depressive symptoms, while the overall mindset toward the ICD device was positive and improved during the one-year follow-up.
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Affiliation(s)
- Revital Amiaz
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Elad Asher
- Davidai Arrhythmia Center, Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Rozen
- Davidai Arrhythmia Center, Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Czerniak
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Levi
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Mark Weiser
- Psychiatry Department, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Glikson
- Davidai Arrhythmia Center, Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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18
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Prevalence and risk markers of early psychological distress after ICD implantation in the European REMOTE-CIED study cohort. Int J Cardiol 2017; 240:208-213. [DOI: 10.1016/j.ijcard.2017.03.124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/13/2017] [Accepted: 03/27/2017] [Indexed: 11/19/2022]
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19
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Psychometric Testing of the Emotional Responses Post Implantable Cardioverter Defibrillator Scale. J Nurs Meas 2017; 25:305-313. [PMID: 28789753 DOI: 10.1891/1061-3749.25.2.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The implantable cardioverter (ICD) is the mainstay of treatment for patients at risk for and those who have had life threatening arrhythmias. The negative emotional responses are important for clinicians to identify. The purpose of this study was to develop and evaluate the psychometric properties of The Emotional Responses Post Implantable Cardioverter Defibrillator Scale among patients with ICD. METHODS This study was completed in phases; content validity, construct validity, internal consistency, reliability of the instrument and test-retest reliability. RESULTS The 3 factors are Factor 1, Depressive Symptoms; Factor 2, Anxiety Symptoms; and Factor 3, Fear of the Device. The overall coefficient for the total set of items was .85. Coefficients of the three factors ranged from .80 to .85. CONCLUSION This study provides evidence to support the content, construct validity, and reliability of this scale.
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20
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Ford J. Are Type D personality and depression predictors of anxiety and posttraumatic stress symptoms among ICD patients? Pacing Clin Electrophysiol 2017; 40:815-816. [DOI: 10.1111/pace.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/28/2017] [Accepted: 04/18/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Jessica Ford
- Department of Psychology; East Carolina University
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21
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Vilchinsky N, Ginzburg K, Fait K, Foa EB. Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review. Clin Psychol Rev 2017; 55:92-106. [DOI: 10.1016/j.cpr.2017.04.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 04/18/2017] [Accepted: 04/23/2017] [Indexed: 11/25/2022]
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22
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Manuel A, Brunger F. Embodying a New Meaning of Being At Risk: Living With an Implantable Cardioverter Defibrillator for Arrhythmogenic Right Ventricular Cardiomyopathy. Glob Qual Nurs Res 2017; 3:2333393616674810. [PMID: 28462346 PMCID: PMC5342860 DOI: 10.1177/2333393616674810] [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: 06/27/2016] [Revised: 09/20/2016] [Accepted: 09/27/2016] [Indexed: 11/16/2022] Open
Abstract
Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D) is a genetic condition that can cause fatal arrhythmias. The implantable cardioverter defibrillation (ICD) is a primary treatment for ARVC/D. Using a grounded theory approach, this study examines the experiences of 15 individuals living with an ICD. The ability to cope with and adjust to having an ICD is influenced by the acceptance of the ICD as something needed to survive, an understanding of the ICD's function, existing support networks, and ones' ability to manage everyday challenges. Coping well requires reshaping ideas about the meaning of being at risk and understanding how the ICD fits into that changing personal risk narrative. A thorough understanding of the unique needs of individuals with ARVC/D and of the specific factors contributing to the psychosocial distress related to having an ICD (vs. having the disease itself) is needed. Nurses must be prepared to provide ongoing support and education to this population.
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Affiliation(s)
- April Manuel
- Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Fern Brunger
- Memorial University, St. John's, Newfoundland and Labrador, Canada
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23
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Norekvål TM, Kirchhof P, Fitzsimons D. Patient-centred care of patients with ventricular arrhythmias and risk of sudden cardiac death: What do the 2015 European Society of Cardiology guidelines add? Eur J Cardiovasc Nurs 2017; 16:558-564. [PMID: 28372463 DOI: 10.1177/1474515117702558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nurses and allied professionals are at the forefront of care delivery in patients with arrythmogenic risk and have a responsibility to deliver care that is focused on their individual needs. The 2015 European Society of Cardiology guideline on prevention of ventricular arrhythmia and sudden cardiac death heralds a step-change in patient and family focus and interdisciplinary involvement. This development reflects a recognition within the European Society of Cardiology that chronic care of patients with cardiovascular conditions can be improved by involving all stakeholders, making use of multidisciplinary interventions, and placing the patient at the centre of the care process. In this article, taskforce contributors discuss the latest evidence and highlight some of the most pertinent issues for nurses involved in patient-centred care of patients and families with ventricular arrhythmias and/or risk of sudden death.
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Affiliation(s)
- Tone M Norekvål
- 1 Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,2 Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Paulus Kirchhof
- 3 Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.,4 Sandwell and West Birmingham Hospitals National Health Service Trust, Birmingham, UK
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24
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Ng CY, Mela T. A Primer on Cardiac Devices: Psychological and Pharmacological Considerations. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20161107-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Caleshu C, Kasparian NA, Edwards KS, Yeates L, Semsarian C, Perez M, Ashley E, Turner CJ, Knowles JW, Ingles J. Interdisciplinary psychosocial care for families with inherited cardiovascular diseases. Trends Cardiovasc Med 2016; 26:647-53. [DOI: 10.1016/j.tcm.2016.04.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 04/23/2016] [Accepted: 04/23/2016] [Indexed: 12/21/2022]
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26
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Richards K, Kramer Freeman L, Sears SF. The Influence of Social Media Use, Online Information Seeking, and Acceptance on Implantable Cardioverter Defibrillator Patient Shock Anxiety. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2016. [DOI: 10.1080/15398285.2016.1201787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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Roberts CR, Wofford JE, Hoy HM, Faddis MN. Implementation of a Screening Program for Patients at Risk for Posttraumatic Stress Disorder. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2016; 10:129-37. [PMID: 27547041 PMCID: PMC4978196 DOI: 10.4137/cmc.s39957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/27/2016] [Accepted: 07/16/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Implantable cardioverter defibrillator (ICD) recipients who suffer from posttraumatic stress disorder (PTSD) are known to be associated with significant cardiac-specific mortality. Clinical observations suggest that PTSD is frequently undetected in ICD recipients followed up at electrophysiology (EP) outpatient clinics. Early recognition of PTSD is important to reduce the risk of serious manifestations on patient outcomes. METHODS All ICD recipients aged 19 years or older at the Washington University School of Medicine (WASHU) EP clinic, a large urban EP clinic, were invited to participate in the project. An informed consent letter with an attached primary care: posttraumatic stress disorder (PC: PTSD) survey was offered to the participants who met the inclusion criteria. Those who completed the survey were included in the project. Individuals with positive survey result were offered a referral to mental health services. Comparisons between PTSD and non-PTSD patients were done using a two-sample t-test for continuous variables. Using Fisher’s exact test, PTSD prevalence was compared to the study by Ladwig et al in which prevalence was determined as the proportion of patients with positive findings of PTSD (n = 38/147). All analyses were conducted using SAS v9.4. The proportion of patients having PTSD was determined and an exact 95% confidence interval was evaluated based on the binomial distribution. RESULTS Using a convenience sample, 50 ICD recipients (33 males and 17 females) were enrolled. The project had a 30-day outcome period. Nine (18%) of the 50 participants had positive PC: PTSD findings and all these nine participants were referred to a mental health specialist. The current project demonstrated an 18% (9/50) PTSD prevalence rate when compared to a 26% (38/147) prevalence rate in the study by Ladwig et al (P = 0.34). Although this project did not demonstrate 20% PTSD prevalence rate, as hypothesized, the 18% PTSD prevalence rate is consistent with previous research. CONCLUSION The prevalence of PTSD noted in the current project is consistent with previous research and validates underrecognition of PTSD in ICD patients. Offering a referral to all ICD recipients at EP clinic visits with a positive PC: PTSD screening to a mental health specialist is an important step in reducing the risk of serious manifestations on patient outcomes.
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Affiliation(s)
- Carmen R Roberts
- Washington University School of Medicine Nurse Practitioner, Cardiac Electrophysiology, USA
| | - Joanie E Wofford
- University of Alabama in Huntsville, Clinical Assistant Professor, Graduate Programs, USA
| | - Haley M Hoy
- University of Alabama in Huntsville, Associate Dean, Graduate Programs Associate Professor, USA
| | - Mitchell N Faddis
- Washington University School of Medicine Associate Professor, Medicine Division of Cardiovascular Diseases, Section Head, Cardiac Electrophysiology, USA
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Serber ER, Fava JL, Christon LM, Buxton AE, Goldberger JJ, Gold MR, Rodrigue JR, Frisch MB. Positive Psychotherapy to Improve Autonomic Function and Mood in ICD Patients (PAM-ICD): Rationale and Design of an RCT Currently Underway. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:458-70. [PMID: 26813033 DOI: 10.1111/pace.12820] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 01/17/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Improving mental and physical health of patients with implantable cardioverter defibrillators (ICD) is critical because this group is at high risk for ventricular arrhythmias and sudden death and depressed or anxious cardiovascular disease (CVD) patients appear to be at even higher risk for mortality compared to nondepressed or nonanxious CVD patients. Further, autonomic dysfunction is present in these patients, and negative emotions and arrhythmias form a downward spiral further worsening mood, well-being, and cardiovascular health. Much research demonstrates that positive emotion is related to health benefits, improved physiology, and increased survival. METHODS AND RESULTS This is a two-arm randomized controlled trial aiming to recruit 60 adult ICD patients comparing 12 individually delivered, weekly sessions of: (1) a positive emotion-focused cognitive-behavioral therapy (Quality of Life Therapy [QOLT]), and (2) Heart Healthy Education. Autonomic functioning, heart rhythm indices, and psychosocial health are measured at baseline, 3 months, and 9 months. The first goal is feasibility and acceptability, with the primary outcome being arrhythmic event frequency data. CONCLUSION This study is designed to test whether QOLT produces changes in mood, quality of life/well-being, autonomic function, and arrhythmic and ICD therapy event rates. This feasibility trial is a foundational step for the next trial of QOLT to help determine whether a 3-month QOLT trial can reduce arrhythmias occurrences among ICD patients, and examine a mechanism of autonomic functioning. This study may help to develop and implement new medical or psychological therapies for ICD patients.
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Affiliation(s)
- Eva R Serber
- Medical University of South Carolina, Charleston, South Carolina
| | - Joseph L Fava
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | | | - Alfred E Buxton
- Beth Israel Deaconess Medical Center and Harvard University, Boston, Massachusetts
| | | | - Michael R Gold
- Medical University of South Carolina, Charleston, South Carolina
| | - James R Rodrigue
- Beth Israel Deaconess Medical Center and Harvard University, Boston, Massachusetts
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Miller JL, Thylén I, Moser DK. Gender Disparities in Symptoms of Anxiety, Depression, and Quality of Life in Defibrillator Recipients. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 39:149-59. [PMID: 26856629 DOI: 10.1111/pace.12786] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 10/20/2015] [Accepted: 11/10/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Most patients cope well with an implantable cardioverter defibrillator (ICD), but psychological distress and ICD-related concerns have been reported in about 20% of ICD recipients. Many previous studies have not distinguished between genders. METHODS In this nationwide study we compared quality of life, anxiety, and depression symptoms between the genders in ICD recipients, and determined predictors of each of these variables in men and women. All adult Swedish ICD recipients were invited by mail to participate and 2,771 patients (66 ± 12 years) completed standardized measures of quality of life, symptoms of anxiety, and depression. Time since implantation ranged from 1 year to 23 years with a mean of 4.7 ± 3.9. RESULTS Women reported worse quality of life (mean index 0.790 vs 0.825) and higher prevalence of anxiety (20.5% vs 14.7%) than did men (P < 0.001 for both comparisons), while there were no differences in symptoms of depression (8.8% vs 8.2%). CONCLUSIONS Most ICD recipients report a good quality of life, without emotional distress, but among the minority with distress, women fare worse than men.
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Affiliation(s)
| | - Ingela Thylén
- Department of Cardiology and Department of Medical and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, Kentucky
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Dougherty CM, Fairbanks AM, Eaton LH, Morrison ML, Kim MS, Thompson EA. Comparison of patient and partner quality of life and health outcomes in the first year after an implantable cardioverter defibrillator (ICD). J Behav Med 2015; 39:94-106. [PMID: 26345262 DOI: 10.1007/s10865-015-9671-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/13/2015] [Indexed: 02/04/2023]
Abstract
Recovery following an implantable cardioverter defibrillator (ICD) impacts both the patient and partner, often in divergent ways. Patients may have had a cardiac arrest or cardiac arrhythmias, whereas partners may have to perform CPR and manage the ongoing challenges of heart disease therapy. Currently, support for post-ICD care focuses primarily on restoring patient functioning with few interventions available to partners who serve as primary support. This descriptive study examined and compared patterns of change for both patients and partners during the first year post-ICD implantation. For this longitudinal study, the sample included 42 of 55 (76.4 %) patient-partner dyads who participated in the 'usual care' group of a larger intervention RCT with patients following ICD implant for secondary prevention of cardiac arrest. Measures taken at across five time points (at hospital discharge and at 1, 3, 6 and 12 months follow up) tracked physical function (SF-12 PCS, symptoms); psychological adjustment (SF-12 MCS; State-Trait Anxiety Inventory; CES-D); relationship impact (Family Functioning, DOII; Mutuality and Interpersonal Sensitivity, MIS); and healthcare utilization (ED visits, outpatient visits, hospitalizations). Repeated measures analysis of variance was used to characterize and compare outcome trends for patients and partners across the first 12 months of recovery. Patients were 66.5 ± 11.3 (mean + SD) years old, predominately Caucasian male (91 %), with Charlson co-morbidities of 4.4 ± 2.4. Partners were 62.5 ± 11.1 years old, predominantly female (91 %) with Charlson co-morbidities of 2.9 ± 3.0. Patient versus partner differences were observed in the pattern of physical health (F = 10.8, p < 0.0001); patient physical health improved while partner health showed few changes. For partners compared to patients, anxiety, depression, and illness demands on family functioning tended to be higher. Patient mutuality was stable, while partner mutuality increased steadily (F = 2.5, p = 0.05). Patient sensitivity was highest at discharge and declined; partner sensitivity increased (F = 10.2, p < 0.0001) across the 12-month recovery. Outpatient visits for patients versus partners differed (F = 5.0, p = 0.008) due most likely to the number of required patient ICD visits. Total hospitalizations and ED visits were higher for patients versus partners, but not significantly. The findings highlight the potential reciprocal influences of patient and partner responses to the ICD experience on health outcomes. Warranted are new, sound and feasible strategies to counterbalance partner needs while simultaneously optimizing patient recovery outcomes.
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Affiliation(s)
- Cynthia M Dougherty
- Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, 1959 NE Pacific Street, HSB T615A, Box 357266, Seattle, WA, 98195-7266, USA.
| | | | - Linda H Eaton
- University of Washington School of Nursing, Seattle, WA, USA
| | | | - Mi Sun Kim
- University of Washington School of Nursing, Seattle, WA, USA
| | - Elaine A Thompson
- Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA, USA
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace 2015; 17:1601-87. [PMID: 26318695 DOI: 10.1093/europace/euv319] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 2015; 36:2793-2867. [PMID: 26320108 DOI: 10.1093/eurheartj/ehv316] [Citation(s) in RCA: 2563] [Impact Index Per Article: 284.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
MESH Headings
- Acute Disease
- Aged
- Anti-Arrhythmia Agents/therapeutic use
- Arrhythmias, Cardiac/genetics
- Arrhythmias, Cardiac/therapy
- Autopsy/methods
- Cardiac Resynchronization Therapy/methods
- Cardiomyopathies/complications
- Cardiomyopathies/therapy
- Cardiotonic Agents/therapeutic use
- Catheter Ablation/methods
- Child
- Coronary Artery Disease/complications
- Coronary Artery Disease/therapy
- Death, Sudden, Cardiac/prevention & control
- Defibrillators
- Drug Therapy, Combination
- Early Diagnosis
- Emergency Treatment/methods
- Female
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/therapy
- Heart Transplantation/methods
- Heart Valve Diseases/complications
- Heart Valve Diseases/therapy
- Humans
- Mental Disorders/complications
- Myocardial Infarction/complications
- Myocardial Infarction/therapy
- Myocarditis/complications
- Myocarditis/therapy
- Nervous System Diseases/complications
- Nervous System Diseases/therapy
- Out-of-Hospital Cardiac Arrest/therapy
- Pregnancy
- Pregnancy Complications, Cardiovascular/therapy
- Primary Prevention/methods
- Quality of Life
- Risk Assessment
- Sleep Apnea, Obstructive/complications
- Sleep Apnea, Obstructive/therapy
- Sports/physiology
- Stroke Volume/physiology
- Terminal Care/methods
- Ventricular Dysfunction, Left/complications
- Ventricular Dysfunction, Left/therapy
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VERKERK AGNESJ, VERMEER ALEXAM, SMETS ELLENM, DEKKER LUKASR, WILDE ARTHURA, VAN LANGEN IRENEM, CHRISTIAANS IMKE, NIEUWKERK PYTHIAT. Quality of Life in Young Adult Patients with a Cardiogenetic Condition Receiving an ICD for Primary Prevention of Sudden Cardiac Death. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 38:870-7. [DOI: 10.1111/pace.12649] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/03/2015] [Accepted: 04/12/2015] [Indexed: 11/30/2022]
Affiliation(s)
- AGNES J. VERKERK
- Department of Clinical and Experimental Cardiology, Heart Centre AMC; Academic Medical Center; Amsterdam the Netherlands
| | - ALEXA M. VERMEER
- Department of Clinical Genetics; Academic Medical Center; Amsterdam the Netherlands
| | - ELLEN M. SMETS
- Department of Medical Psychology; Academic Medical Center; Amsterdam the Netherlands
| | - LUKAS R. DEKKER
- Department of Cardiology; Catharina Hospital; Eindhoven the Netherlands
| | - ARTHUR A. WILDE
- Department of Clinical and Experimental Cardiology, Heart Centre AMC; Academic Medical Center; Amsterdam the Netherlands
| | - IRENE M. VAN LANGEN
- Department of Clinical Genetics; University Medical Center Groningen; Groningen the Netherlands
| | - IMKE CHRISTIAANS
- Department of Clinical Genetics; Academic Medical Center; Amsterdam the Netherlands
| | - PYTHIA T. NIEUWKERK
- Department of Medical Psychology; Academic Medical Center; Amsterdam the Netherlands
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Manzoni GM, Castelnuovo G, Compare A, Pagnini F, Essebag V, Proietti R. Psychological effects of implantable cardioverter defibrillator shocks. A review of study methods. Front Psychol 2015; 6:39. [PMID: 25698991 PMCID: PMC4316692 DOI: 10.3389/fpsyg.2015.00039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 01/08/2015] [Indexed: 11/13/2022] Open
Abstract
Background: The implantable cardioverter defibrillator (ICD) saves lives but clinical experience suggests that it may have detrimental effects on mental health. The ICD shock has been largely blamed as the main offender but empirical evidence is not consistent, perhaps because of methodological differences across studies. Objective: To appraise methodologies of studies that assessed the psychological effects of ICD shock and explore associations between methods and results. Data Sources: A comprehensive search of English articles that were published between 1980 and 30 June 2013 was applied to the following electronic databases: PubMed, EMBASE, NHS HTA database, PsycINFO, Sciencedirect and CINAHL. Review Methods: Only studies testing the effects of ICD shock on psychological and quality of life outcomes were included. Data were extracted according to a PICOS pre-defined sheet including methods and study quality indicators. Results: Fifty-four observational studies and six randomized controlled trials met the inclusion criteria. Multiple differences in methods that were used to test the psychological effects of ICD shock were found across them. No significant association with results was observed. Conclusions: Methodological heterogeneity of study methods is too wide and limits any quantitative attempt to account for the mixed findings. Well-built and standardized research is urgently needed.
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Affiliation(s)
- Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy ; Department of Psychology, Catholic University of Milan Milano, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS Verbania, Italy ; Department of Psychology, Catholic University of Milan Milano, Italy
| | - Angelo Compare
- Department of Psychology, University of Bergamo Bergamo, Italy
| | - Francesco Pagnini
- Department of Psychology, Catholic University of Milan Milano, Italy
| | - Vidal Essebag
- McGill University Health Center Montreal, QC, Canada
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Thylén I, Dekker RL, Jaarsma T, Strömberg A, Moser DK. Characteristics associated with anxiety, depressive symptoms, and quality-of-life in a large cohort of implantable cardioverter defibrillator recipients. J Psychosom Res 2014; 77:122-7. [PMID: 25077853 DOI: 10.1016/j.jpsychores.2014.05.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 05/21/2014] [Accepted: 05/22/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although most patients with implantable cardioverter defibrillators (ICDs) adjust well, some have considerable psychological distress. Factors associated with psychological adjustment in ICD-recipients are still not well understood. Our purpose was to describe quality-of-life (QoL) and prevalence of self-reported symptoms of anxiety and depression in a large national cohort of ICD-recipients, and to determine socio-demographic, clinical, and ICD-related factors associated with these variables. METHODS A cross-sectional, correlational design was used. All eligible adult ICD-recipients in the Swedish ICD- and Pacemaker Registry were invited to participate. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), and QoL with the EuroQol-5D. RESULTS A total of 3067 ICD-recipients (66±11years, 80% male) were included. The mean HADS score was 3.84±3.70 for anxiety symptoms and 2.99±3.01 for symptoms of depression. The mean EQ-5D index score was 0.82±0.21. The probability of symptoms of anxiety and depression was associated with younger age, living alone, and a previous history of myocardial infarction or heart failure. Additionally, female ICD-recipients had a higher probability of symptoms of anxiety. A higher level of ICD-related concerns was most prominently related to symptoms of anxiety, depressive symptoms and poorer QoL, while number of shocks, ICD-indication and time since implantation were not independently related. CONCLUSIONS In this large cohort of ICD-recipients, the association of ICD-related concerns with symptoms of anxiety, depressive symptoms, and poor QoL suggests that ICD specific factors should be addressed in order to improve outcomes.
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Affiliation(s)
- Ingela Thylén
- Department of Cardiology and Department of Medicine and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden.
| | - Rebecca L Dekker
- College of Nursing, University of Kentucky, Lexington, United States.
| | - Tiny Jaarsma
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
| | - Anna Strömberg
- Department of Cardiology and Department of Medicine and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden.
| | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, United States.
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The impact of technology dependency on device acceptance and quality of life in persons with implantable cardioverter defibrillators. J Cardiovasc Nurs 2014; 28:E65-73. [PMID: 23348222 DOI: 10.1097/jcn.0b013e31827b9789] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The impact of implantable cardioverter defibrillator (ICD) technology on the quality of life (QOL) experienced by recipients has been a major focus of recent research. Numerous studies have found psychological distress to be important in determining QOL in persons receiving ICDs, yet the source of psychological distress is not well understood. OBJECTIVE The aim of this study was to determine the impact of technology dependency on psychological outcomes in ICD recipients. METHODS With the use of a cross-sectional design, 161 ICD recipients from 1 device clinic were mailed self-administered questionnaires, including the Dependency on Technology Scale, Brief Illness Perception Questionnaire, Florida Shock Anxiety Scale, Florida Patient Acceptance Survey, and Short Form-12 (SF-12). Hierarchical multiple regressions and analyses of variance were performed. RESULTS The final sample size was 101 participants. Mean (SD) age was 68 (13) years; 72% of the participants were men, 99% were white, and 30% reported receiving a shock(s). A total of 80% reported positive attitudes toward technology dependency; 14%, neutral; and 6%, negative (Dependency on Technology Scale). Illness perceptions were positive (Brief Illness Perception Questionnaire; mean[SD], 34.5 [12.6]), shock anxiety was elevated (Florida Shock Anxiety Scale; mean [SD], 16.5 [6.7]), and device acceptance was good (Florida Patient Acceptance Survey; mean [SD], 74.9 [17.0]). Physical health QOL was low (SF-12; mean [SD], 38.6 [11.3]) and mental health QOL was moderate (SF-12; mean [SD], 50.6 [10.0]). Attitudes toward technology dependency significantly accounted for the variance seen in device acceptance and mental health QOL beyond age, gender, number of shocks, illness perceptions, and shock anxiety by 5.7% (P = .001) and 3.3% (P = .04), respectively. Significant differences were seen in device acceptance between those with negative and neutral attitudes (P = .001) and those with negative and positive attitudes (P < .001) and in shock anxiety and mental health QOL between those with negative and those with positive attitudes (P < .001). CONCLUSIONS Attitudes toward technology dependency is significantly associated with psychological outcomes and may explain the psychological distress in some ICD recipients. Degree of positivity toward technology dependency influences these outcomes. Research evaluating attitudes toward technology dependency and testing of interventions focusing on these attitudes is warranted.
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Wong FMF, Sit JWH, Wong EML, Choi KC. Factors associated with health-related quality of life among patients with implantable cardioverter defibrillator: identification of foci for nursing intervention. J Adv Nurs 2014; 70:2821-34. [DOI: 10.1111/jan.12434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2014] [Indexed: 12/01/2022]
Affiliation(s)
| | - Janet Wing Hung Sit
- The Chinese University of Hong Kong; the Nethersole School of Nursing; Hong Kong
| | - Eliza Mi Ling Wong
- The Chinese University of Hong Kong; the Nethersole School of Nursing; Hong Kong
| | - Kai Chow Choi
- The Chinese University of Hong Kong; the Nethersole School of Nursing; Hong Kong
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Post‐traumatic stress disorder and its risk factors in Japanese patients living with implantable cardioverter defibrillators: A preliminary examination. J Arrhythm 2014. [DOI: 10.1016/j.joa.2013.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Making Decisions About Implantable Cardioverter-Defibrillators from Implantation to End of Life: An Integrative Review of Patients’ Perspectives. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2014; 7:243-60. [DOI: 10.1007/s40271-014-0055-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Berg SK, Pedersen PU, Zwisler AD, Winkel P, Gluud C, Pedersen BD, Svendsen JH. Comprehensive cardiac rehabilitation improves outcome for patients with implantable cardioverter defibrillator. Findings from the COPE-ICD randomised clinical trial. Eur J Cardiovasc Nurs 2014; 14:34-44. [PMID: 24504872 DOI: 10.1177/1474515114521920] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIMS The aim of this randomised clinical trial was to assess a comprehensive cardiac rehabilitation intervention including exercise training and psycho-education vs 'treatment as usual' in patients treated with an implantable cardioverter defibrillator (ICD). METHODS In this study 196 patients with first time ICD implantation (mean age 57.2 (standard deviation (SD)=13.2); 79% men) were randomised (1:1) to comprehensive cardiac rehabilitation vs 'treatment as usual'. Altogether 144 participants completed the 12 month follow-up. The intervention consisted of twelve weeks of exercise training and one year of psycho-educational follow-up focusing on modifiable factors associated with poor outcomes. Two primary outcomes, general health score (Short Form-36 (SF-36)) and peak oxygen uptake (VO₂), were used. Post-hoc analyses included SF-36 and ICD therapy history. RESULTS Comprehensive cardiac rehabilitation significantly increased VO2 uptake after exercise training to 23.0 (95% confidence interval (CI) 20.9-22.7) vs 20.8 (95% CI 18.9-22.7) ml/min/kg in the control group (p=0.004 (multiplicity p=0.015)). Comprehensive cardiac rehabilitation significantly increased general health; at three months (mean 62.8 (95% CI 58.1-67.5) vs 64.4 (95% CI: 59.6-69.2)) points; at six months (mean 66.7 (95% CI 61.5-72.0) vs 61.9 (95% CI 56.1-67.7) points); and 12 months (mean 63.5 (95% CI 57.7-69.3) vs 62.1 (95% CI 56.2-68.0)) points (p <0.05). Explorative analyses showed a significant difference between groups in favour of the intervention group. No significant difference was seen in ICD therapy history. CONCLUSION Comprehensive cardiac rehabilitation combining exercise training and a psycho-educational intervention improves VO₂-uptake and general health. Furthermore, mental health seems improved. No significant difference was found in the number of ICD shocks or anti-tachycardia pacing therapy.
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Affiliation(s)
| | - Preben U Pedersen
- Centre of Clinical Guidelines - Clearinghouse, Faculty of Medicine and Technology, Aalborg University, Denmark
| | - Ann-Dorthe Zwisler
- The Heart Centre Unit 2151, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Per Winkel
- Centre for Clinical Intervention Research Unit 3344, Copenhagen University Hospital, Denmark
| | - Christian Gluud
- Centre for Clinical Intervention Research Unit 3344, Copenhagen University Hospital, Denmark
| | | | - Jesper H Svendsen
- Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark
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Jordan J, Titscher G, Peregrinova L, Kirsch H. Manual for the psychotherapeutic treatment of acute and post-traumatic stress disorders following multiple shocks from implantable cardioverter defibrillator (ICD). PSYCHO-SOCIAL MEDICINE 2013; 10:Doc09. [PMID: 24403967 PMCID: PMC3884562 DOI: 10.3205/psm000099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In view of the increasing number of implanted cardioverter defibrillators (ICD), the number of people suffering from so-called "multiple ICD shocks" is also increasing. The delivery of more than five shocks (appropriate or inappropriate) in 12 months or three or more shocks (so called multiple shocks) in a short time period (24 hours) leads to an increasing number of patients suffering from severe psychological distress (anxiety disorder, panic disorder, adjustment disorder, post-traumatic stress disorder). Untreated persons show chronic disease processes and a low rate of spontaneous remission and have an increased morbidity and mortality. Few papers have been published concerning the psychotherapeutic treatment for these patients. OBJECTIVE The aim of this study is to develop a psychotherapeutic treatment for patients with a post-traumatic stress disorder or adjustment disorder after multiple ICD shocks. DESIGN Explorative feasibility study: Treatment of 22 patients as a natural design without randomisation and without control group. The period of recruitment was three years, from March 2007 to March 2010. The study consisted of two phases: in the first phase (pilot study) we tested different components and dosages of psychotherapeutic treatments. The final intervention programme is presented in this paper. In the second phase (follow-up study) we assessed the residual post-traumatic stress symptoms in these ICD patients. The time between treatment and follow-up measurement was 12 to 30 months. POPULATION Thirty-one patients were assigned to the Department of Psychocardiology after multiple shocks. The sample consisted of 22 patients who had a post-traumatic stress disorder or an adjustment disorder and were willing and able to participate. They were invited for psychological treatment. 18 of them could be included into the follow-up study. METHODS After the clinical assessment at the beginning and at the end of the inpatient treatment a post-treatment assessment with questionnaires followed. In this follow-up measurement, minimum 12 months after inpatient treatment, posttraumatic stress was assessed using the "Impact of Event Scale" (IES-R). SETTING Inpatient treatment in a large Heart and Thorax Centre with a Department of Psychocardiology (Kerckhoff Heart Centre). RESULTS From the 18 patients in the follow-up study no one reported complaints of PTSD. 15 of them reported a high or even a very high decrease of anxiety and avoidance behaviour. CONCLUSIONS The fist step of the treatment development seems to be successful. It shows encouraging results with an acceptable dosage. The second step of our work is in process now: we evaluate the treatment manual within other clinical institutions and a higher number of psychotherapists. This leads in the consequence to a controlled and randomised comparison study.
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Affiliation(s)
- Jochen Jordan
- Department of Psychocardiology, Kerckhoff Clinic Heart and Thorax Center, Bad Nauheim, Germany
| | | | - Ludmila Peregrinova
- Department of Psychocardiology, Kerckhoff Clinic Heart and Thorax Center, Bad Nauheim, Germany
| | - Holger Kirsch
- Evangelische Hochschule (University of Applied Sciences), Darmstadt, Germany
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LANG SASKIA, BECKER RÜDIGER, WILKE STEFANIE, HARTMANN MECHTHILD, HERZOG WOLFGANG, LÖWE BERND. Anxiety Disorders in Patients with Implantable Cardioverter Defibrillators: Frequency, Course, Predictors, and Patients’ Requests for Treatment. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 37:35-47. [DOI: 10.1111/pace.12276] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/24/2013] [Accepted: 08/12/2013] [Indexed: 12/31/2022]
Affiliation(s)
- SASKIA LANG
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - RÜDIGER BECKER
- Department of Cardiology; University of Heidelberg; Heidelberg Germany
| | - STEFANIE WILKE
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - MECHTHILD HARTMANN
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - WOLFGANG HERZOG
- Department of General Internal Medicine and Psychosomatics; University of Heidelberg; Heidelberg Germany
| | - BERND LÖWE
- Department of Psychosomatic Medicine and Psychotherapy; University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek; Hamburg Germany
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Morken IM, Bru E, Norekvål TM, Larsen AI, Idsoe T, Karlsen B. Perceived support from healthcare professionals, shock anxiety and post-traumatic stress in implantable cardioverter defibrillator recipients. J Clin Nurs 2013; 23:450-60. [DOI: 10.1111/jocn.12200] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Ingvild M Morken
- Department of Cardiology; Stavanger University Hospital; Stavanger Norway
- Department of Health Studies; University of Stavanger; Stavanger Norway
| | - Edvin Bru
- Department of Health Studies; University of Stavanger; Stavanger Norway
- Centre for Behavioural Research; University of Stavanger; Stavanger Norway
| | - Tone M Norekvål
- Department of Heart Disease; Haukeland University Hospital; Bergen Norway
- Institute of Medicine; University of Bergen; Bergen Norway
| | - Alf I Larsen
- Department of Cardiology; Stavanger University Hospital; Stavanger Norway
- Institute of Medicine; University of Bergen; Bergen Norway
| | - Thormod Idsoe
- Centre for Behavioural Research; University of Stavanger; Stavanger Norway
- Norwegian
Institute of Public Health; Oslo Norway
| | - Bjørg Karlsen
- Department of Health Studies; University of Stavanger; Stavanger Norway
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Shiga T, Suzuki T, Nishimura K. Psychological distress in patients with an implantable cardioverter defibrillator. J Arrhythm 2013. [DOI: 10.1016/j.joa.2013.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Knackstedt C, Arndt M, Mischke K, Marx N, Nieman F, Kunert HJ, Schauerte P, Norra C. Depression, psychological distress, and quality of life in patients with cardioverter defibrillator with or without cardiac resynchronization therapy. Heart Vessels 2013; 29:364-74. [PMID: 23732755 DOI: 10.1007/s00380-013-0372-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
Abstract
Congestive heart failure is frequent and leads to reduced exercise capacity, reduced quality of life (QoL), and depression in many patients. Cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillators (ICD) offer therapeutic options and may have an impact on QoL and depression. This study was performed to evaluate physical and mental health in patients undergoing ICD or combined CRT/ICD-implantation (CRT-D). Echocardiography, spiroergometry, and psychometric questionnaires [Beck Depression Inventory, General World Health Organization Five Well-being Index (WHO-5), Brief Symptom Inventory and 36-item Short Form (SF-36)] were obtained in 39 patients (ICD: 17, CRT-D: 22) at baseline and 6-month follow-up (FU) after device implantation. CRT-D patients had a higher NYHA class and broader left bundle branch block than ICD patients at baseline. At FU, ejection fraction (EF), peak oxygen uptake, and NYHA class improved significantly in CRT-D patients but remained unchanged in ICD patients. Patients with CRT-D implantation showed higher levels of depressive symptoms, psychological distress, and impairment in QoL at baseline and FU compared to ICD patients. These impairments remained mostly unchanged in all patients after 6 months. Overall, these findings imply that there is a need for careful assessment and treatment of psychological distress and depression in ICD and CRT-D patients in the course of device implantation as psychological burden seems to persist irrespective of physical improvement.
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Affiliation(s)
- Christian Knackstedt
- Department of Cardiology, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands,
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Pedersen SS, Hoogwegt MT, Jordaens L, Theuns DA. Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12months post implantation. Int J Cardiol 2013; 166:215-20. [DOI: 10.1016/j.ijcard.2011.10.092] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 09/18/2011] [Accepted: 10/18/2011] [Indexed: 11/15/2022]
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de Ornelas Maia ACC, Soares-Filho G, Pereira V, Nardi AE, Silva AC. Psychiatric disorders and quality of life in patients with implantable cardioverter defibrillators: a systematic review. Prim Care Companion CNS Disord 2013; 15:PCC.12r01456. [PMID: 23930235 PMCID: PMC3733528 DOI: 10.4088/pcc.12r01456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/16/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To systematically review the literature with regard to psychiatric disorders and quality of life in patients with an implantable cardioverter defibrillator. DATA SOURCES Research was conducted in 3 databases (ISI Web of Science, PubMed, and PsycINFO) using the terms implantable, cardioverter, defibrillator, quality of life, psych *, anxiety, and depression. STUDY SELECTION The search yielded 1,399 references. Non-English and repeated references were excluded. After abstract analysis, 42 references were recovered for full-text reading, and 25 articles were selected for this review. DATA EXTRACTION Research took place in April 2012, and no time restriction was placed on any of the database searches. Review or theoretical articles were excluded, and only clinical trials and epidemiologic studies were selected for this review. RESULTS A systematic review of the literature revealed mostly observational prospective cohort studies followed by cross-sectional observational studies and randomized clinical trials. Few studies included in the review were observational retrospective cohort or case-control studies. There are prominent signs and symptoms of anxiety and depression in patients with an implantable cardioverter defibrillator. Disorders include phobic anxiety, posttraumatic stress disorder, panic disorder, somatoform disorder, agoraphobia, and depression. Quality of life in the physical, social, and psychological domains is affected and is related to the intensity and the frequency of the device's electrical discharge. CONCLUSIONS Work regarding psychiatric comorbidity in patients with an implantable cardioverter defibrillator has shown that anxiety and depression are common. The patients and their families should be informed by their doctors that the presence of the device minimizes risk of sudden death and allows them to have a normal life.
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Affiliation(s)
- Ana Claudia C de Ornelas Maia
- Laboratory of Panic and Respiration, Institute of Psychiatry (Drs Soares-Filho and Silva and Mss Ornelas Maia and Pereira) and National Institute for Science and Technology, Translational Medicine (Drs Nardi and Silva), Federal University of Rio de Janeiro; and National Institute for Science and Technology, Translational Medicine, Federal University Fluminense (Dr Silva), Rio de Janeiro, Brazil
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Ford J, Sears SF, Shea JB, Cahill J. Cardiology patient page. Coping with trauma and stressful events as a patient with an implantable cardioverter-defibrillator. Circulation 2013; 127:e426-30. [PMID: 23357666 DOI: 10.1161/circulationaha.112.127563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jessica Ford
- East Carolina University, Department of Psychology, 215 Rawl Hall, Greenville, NC 27858, USA
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Trajectories of Perceived Emotional and Physical Distress in Patients with an Implantable Cardioverter Defibrillator. Int J Behav Med 2012; 21:149-59. [DOI: 10.1007/s12529-012-9275-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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