1
|
Hauser RG, Swerdlow CD. What electrophysiologists should know about cardiac implantable electronic device recalls. Heart Rhythm 2024; 21:958-961. [PMID: 38403233 DOI: 10.1016/j.hrthm.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Robert G Hauser
- The Joseph F. Novogratz Family Heart Rhythm Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.
| | - Charles D Swerdlow
- Smidt Heart Institute at Cedars Sinai Medical Center, Los Angeles, California
| |
Collapse
|
2
|
Sudden Death and Ventricular Arrhythmias in Athletes: Screening, De-Training and the Role of Catheter Ablation. Heart Lung Circ 2018; 28:155-163. [PMID: 30554599 DOI: 10.1016/j.hlc.2018.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 01/29/2023]
Abstract
Athletes enjoy excellent health outcomes including greater longevity relative to non-athletic counterparts. Paradoxically, however, endurance athletic conditioning is associated with an increase in some arrhythmias. This review discusses the potential mechanisms for this paradox and strategies enabling early identification of potentially serious pathologies. Screening remains contentious due to the challenges of identifying relatively rare entities amongst a healthy cohort. The imperfect diagnostic accuracy of all current tests means that screening strategies have potential for harm through incorrect diagnoses as well as the potential for identification of important sub-clinical pathologies. Management of athletes at risk of ventricular arrhythmias and sudden cardiac death is similarly complex. There is much yet to learn about the specific patterns of ventricular arrhythmias in athletes, and the separation of benign from potentially life-threatening remains imperfect. There are some promising advances, however, such as specialised imaging modalities combined with improved electrophysiological diagnostics and therapeutics. Some unique clinical patterns are emerging to advance our understanding and management of athletes with ventricular arrhythmias, requiring specialised skillsets for evaluation and management.
Collapse
|
3
|
Goldstein SA, LaPage MJ, Dechert BE, Serwer GA, Yu S, Lowery RE, Bradley DJ. Decreased inappropriate shocks with new generation ICDs in children and patients with congenital heart disease. CONGENIT HEART DIS 2018; 13:413-418. [PMID: 29372620 DOI: 10.1111/chd.12585] [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] [Received: 09/21/2017] [Revised: 11/17/2017] [Accepted: 12/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Inappropriate implantable cardioverter defibrillator (ICD) shocks in children and patients with congenital heart disease (CHD) remain a major complication of device therapy, occurring in as many as 50% of children with ICDs. New generation devices include algorithms designed to minimize inappropriate shocks. This study aimed to evaluate the effect of new generation ICDs on the incidence of inappropriate shocks in the pediatric and CHD population. DESIGN Retrospective study of patients with CHD or under age 25 receiving ICDs between 2000 and 2015. New generation ICDs were defined as those with Medtronic "SmartShock" algorithms. RESULTS Two hundred eight devices were implanted in 146 patients. Rates of inappropriate shocks were similar between diagnoses (P = .71). The rate of inappropriate shock was 15% over median 5.8 years follow-up. In the 36 patients (25%) with new generation ICDs, the rate of inappropriate shock was 6.3% over 4 years. Comparing old to new generation ICDs, freedom from first inappropriate shock was 90.6% versus 97.1% at 1 year and 80.4% versus 97.1% at 3 years (P = .01). Lead fracture was associated with having inappropriate shock (hazard ratio 8.5, P < .0001), and there was no significant difference between the device groups when lead fractures were excluded. Clinical actions were taken in 69% of patients after initial inappropriate shock (such as medication or program change, system revision, or explant). When an action was taken, subsequent inappropriate shock was reduced (5.3% vs 49.2% at 1 year; P = .002). CONCLUSIONS Pediatric and CHD patients are experiencing reduced inappropriate shocks with new generation ICD systems, though reduced lead fracture may account for this improvement. Clinical interventions after inappropriate shock favorably impact the subsequent rate of shocks once an inappropriate shock occurs.
Collapse
Affiliation(s)
| | - Martin J LaPage
- University of Michigan Congenital Heart Center, Ann Arbor, Michigan, USA
| | - Brynn E Dechert
- University of Michigan Congenital Heart Center, Ann Arbor, Michigan, USA
| | - Gerald A Serwer
- University of Michigan Congenital Heart Center, Ann Arbor, Michigan, USA
| | - Sunkyung Yu
- University of Michigan Congenital Heart Center, Ann Arbor, Michigan, USA
| | - Ray E Lowery
- University of Michigan Congenital Heart Center, Ann Arbor, Michigan, USA
| | - David J Bradley
- University of Michigan Congenital Heart Center, Ann Arbor, Michigan, USA
| |
Collapse
|
4
|
Kramer Freeman L, Richards K, Conti JB, Sears SF. Patients With Implantable Cardioverter Defibrillators on Social Media Report More Shock Anxiety Than Clinic Patients: Results From an Online Survey. JMIR Cardio 2017; 1:e6. [PMID: 31758785 PMCID: PMC6857955 DOI: 10.2196/cardio.8152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/18/2017] [Accepted: 08/31/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Coping with heart disease and the potential for implantable cardioverter defibrillator (ICD) shocks challenges the psychological adjustment of patients with ICDs. Social media use may be used to seek education and support from others. OBJECTIVE The aim of this study was to examine the content of information sought online and whether a social media sample of patients with ICDs report more device-specific anxiety than clinic-based normative samples. METHODS A total of 196 participants were recruited via social media messages and invited to complete an online survey. RESULTS It was found that the information most often sought by online users (62.4%, 123/196) involved both emotional support (eg, gaining emotional support from other patients with ICDs) and technical information (52.6%, 103/196) (eg, dealing with magnetic interference). The online sample reported more shock anxiety than a typical clinical sample with mean values of 22.75 (SD 10.06) and 15.18 (SD 6.50), respectively (P<.001). CONCLUSIONS Collectively, these results suggest that patients with ICDs that are online are seeking emotional information and support, and that they report increased shock anxiety relative to typical clinic-based patients. Future research should examine how online information and clinical-based information form a composite understanding and adjustment for patients ICDs.
Collapse
Affiliation(s)
- Linda Kramer Freeman
- Carlson School of Management, University of Minnesota, Minneapolis, MN, United States
| | - Keith Richards
- School of Communication, East Carolina University, Greenville, NC, United States
| | - Jamie B Conti
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Samuel F Sears
- Departments of Psychology and Cardiovascular Sciences, East Carolina University, Greenville, NC, United States
| |
Collapse
|
5
|
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.
Collapse
|
6
|
Zhu DWX, Chu MM, House CM. Management of functional Sprint Fidelis leads at cardiac resynchronization therapy-defibrillator generator replacement: a novel option for preventing inappropriate shocks from lead failure in fragile patients with high risk of sudden death†. Europace 2016; 19:2007-2014. [DOI: 10.1093/europace/euw311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/03/2016] [Indexed: 11/13/2022] Open
|
7
|
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]
|
8
|
De Bardi S, Lorenzoni G, Gregori D. Social support to elderly pacemaker patients improves device acceptance and quality of life. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
9
|
Abstract
Defibrillator lead advisories stir a lot of emotions, both with patients and physicians, and this may influence lead management. We reviewed the literature for a more evidence-based approach to this issue. From the complications of two of the current advisory leads, the Medtronic Sprint Fidelis and St. Jude Riata leads, and the consequences of possible interventions, we can conclude that a restrained approach to premature replacement is appropriate. It may be opportune to replace the leads during a scheduled generator replacement in case of a higher electrical failure rate, in order to prevent future premature interventions. We found no support to extract non-functional advisory leads. In contrast, extraction is often more demanding than anticipated, and the risk substantially exceeds that of simply abandoning the leads.
Collapse
|
10
|
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.
Collapse
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
| | | |
Collapse
|
11
|
Larsen JM, Riahi S, Johansen JB, Nielsen JC, Petersen HH, Haarbo J, Pedersen SS. The patient perspective on the Riata defibrillator lead advisory: A Danish nationwide study. Heart Rhythm 2014; 11:2148-55. [DOI: 10.1016/j.hrthm.2014.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Indexed: 11/24/2022]
|
12
|
Mastenbroek MH, Pedersen SS, Versteeg H, Doevendans PA, Meine M. State of the art of ICD programming: Lessons learned and future directions. Neth Heart J 2014; 22:415-20. [PMID: 25074477 PMCID: PMC4188844 DOI: 10.1007/s12471-014-0582-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The lifesaving benefits of implantable cardioverter defibrillator (ICD) therapy are more and more weighted against possible harm (e.g. unnecessary device therapy, procedural complications, device malfunction etc.) which might have adverse effects on patients' perceived health status and quality of life. Hence, there has been an increasing interest in the optimisation of ICD programming to prevent inappropriate and appropriate but unnecessary device therapy. The purpose of the current report is to give an overview of research into the optimisation of ICD programming and present the design of the on-going ENHANCED-ICD study. The ENHANCED-ICD study is a prospective, safety monitoring study enrolling 60 primary and secondary prophylactic ICD patients at the University Medical Center Utrecht. Patients implanted with any type of ICD with SmartShock technology(TM), and between 18-80 years of age, were eligible to participate. In all patients a prolonged detection of 60/80 intervals was programmed. The primary objective of the study is to investigate whether enhanced programming to further reduce ICD therapies is safe. The secondary objective is to examine the impact of enhanced programming on (i) antitachycardia pacing and shocks (both appropriate and inappropriate) and (ii) quality of life and distress. The first results of the ENHANCED-ICD study are expected in 2015.
Collapse
Affiliation(s)
- M H Mastenbroek
- Cardiology, Department of Heart and Lung, University Medical Center, Heidelberglaan 100, PO Box 85500, 3584 CX, Utrecht, the Netherlands,
| | | | | | | | | |
Collapse
|
13
|
|
14
|
Ottenberg AL, Mueller LA, Mueller PS. Perspectives of patients with cardiovascular implantable electronic devices who received advisory warnings. Heart Lung 2013; 42:59-64. [PMID: 23305915 DOI: 10.1016/j.hrtlng.2012.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 09/24/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To learn the perspectives of patients with cardiovascular implantable electronic devices (CIEDs) who received device-related advisories. BACKGROUND CIEDs are placed under advisory because of potential malfunctions. METHODS Qualitative methods were used. Focus groups were conducted of 10 patients who had CIEDs under advisory. Audio recordings of the focus group discussions were transcribed and analyzed for content in accordance with qualitative analysis methods, specifically thematic analysis. RESULTS Major themes were identified: patients' attitudes toward their devices under advisory, education about advisories, emotional responses to advisories, impact on loved ones, and what affected patients would say to the chief executive officers of CIED manufacturers. Although the patients felt "fortunate and blessed" to have their devices, they reported a range of emotional responses to the advisories (from no concern to "outrage"). Patients preferred to learn about advisories from their physicians, not from news media. Loved ones had as many, if not more, advisory-related concerns than the patients. Patients had recommendations for chief executive officers of CIED manufacturers regarding advisories, including providing timely and comprehensible information and emotional support, taking responsibility, and collaborating with health care providers. Patients wanted to know what prompted the advisory and what will be done to fix the problem. CONCLUSIONS The experiences and perspectives of patients with CIEDs under advisory not only encompass their emotional responses to advisories, but also their views on how the advisory notification process can be improved. These findings should be informative to CIED manufacturers and clinicians.
Collapse
Affiliation(s)
- Abigale L Ottenberg
- Program in Professionalism and Ethics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | |
Collapse
|
15
|
Hayat SA, Kojodjojo P, Mason A, Benfield A, Wright I, Whinnett Z, Lim PB, Davies DW, Lefroy D, Peters NS, Kanagaratnam P. Malfunction of subpectorally implanted cardiac resynchronization therapy defibrillators due to weakened header bond. J Cardiovasc Electrophysiol 2012; 24:351-5. [PMID: 23131091 DOI: 10.1111/j.1540-8167.2012.02421.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Implantable cardioverter defibrillator (ICD) implantation has increased significantly over the last 10 years. Concerns about the safety and reliability of ICD systems have been raised, with premature lead failure and battery malfunctions accounting for the majority of reported adverse events. We describe the unique mode of presentation, diagnosis, and management of cardiac resynchronization therapy defibrillators (CRT-D) malfunctions that were caused by weakened bonding between the generator and header. METHODS AND RESULTS Between June 2008 and December 2009, 22 Teligen™ ICDs and 24 Cognis™ CRT-Ds were implanted subpectorally at our institution, until a product advisory was issued. Of 24 Cognis™ CRT-D implants, 3 patients presented with CRT-D malfunctions. All our cases presented with initially intermittent and then persisting increases in shock lead impedance, associated with nonphysiological noise in the shock electrogram channels. These issues were rectified by generator change. Postexplant laboratory analysis confirmed inadequate bonding between device header and titanium casing in all cases, resulting in loosening and rocking of the header followed by fatigue-induced fracture of the shock circuitry. CONCLUSION Weakened bonding between the header and generator casing of subpectorally implanted CRT-Ds can result in fractures and malfunction of the HV circuit. Physicians monitoring patients with devices affected by the product advisory should remain vigilant in order to diagnose and manage similar device malfunction expediently.
Collapse
Affiliation(s)
- Sajad A Hayat
- Department of Cardiac Electrophysiology, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
D'Antono B, Goldfarb M, Solomon C, Sturmer M, Becker G, Essebag V, Hadjis T, Gizicki E, Gelais JS, Sas G, Côté MC, Kus T. Psychological impact of surveillance in patients with a defibrillator lead under advisory: a prospective evaluation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 36:221-30. [PMID: 23121081 DOI: 10.1111/pace.12040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 08/17/2012] [Accepted: 08/27/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND Implantable cardioverter defibrillator (ICD) leads are subject to technical failures and the impact of the resulting public advisories on patient welfare is unclear. The psychological status of patients who received an advisory for their Medtronic Fidelis ICD lead (Medtronic Inc., Minneapolis, MN, USA) and followed either by self-surveillance for alarm or home monitoring with CareLink was evaluated prospectively and compared to patients with ICDs not under advisory. METHODS One hundred sixty consecutive consenting patients (90 alarms, 24 Carelinks, 46 controls) were recruited within 1.5 years of advisory notification. Advisory patients were seen immediately before being told that the automatic lead surveillance utilized since the advisory had been inadequate in warning of impending fracture, as well as 1 and 6 months after programming was optimized. Depression, anxiety, quality of life (QoL), and ICD-related concerns were assessed. RESULTS Symptoms of depression and state anxiety were experienced by 31% and 48% of patients, respectively. QoL was impaired on all subscales. No significant group differences in distress and ICD-related concerns emerged at baseline or at follow-up. At baseline, alarm patients reported greater limitations because of body pain compared to controls (P < 0.05). All patients showed a significant reduction in body pain-related QoL at the final versus first two evaluations (P < 0.001). Advisory patients were significantly less satisfied with surveillance at follow-up than at baseline (P < 0.05). CONCLUSIONS There was limited evidence for worse psychosocial functioning in those at risk for ICD lead fracture, irrespective of surveillance method. However, many control and advisory patients experienced chronic distress for which counseling may prove beneficial.
Collapse
Affiliation(s)
- Bianca D'Antono
- Research Centre, Montreal Heart Institute/Université de Montréal, Montréal, Canada.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Ford J, Finch JF, Woodrow LK, Cutitta KE, Shea J, Fischer A, Hazelton G, Sears SF. The Florida Shock Anxiety Scale (FSAS) for patients with implantable cardioverter defibrillators: testing factor structure, reliability, and validity of a previously established measure. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:1146-53. [PMID: 22758923 DOI: 10.1111/j.1540-8159.2012.03455.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The implantable cardioverter defibrillator (ICD) reduces mortality in patients at risk for life-threatening arrhythmias via high energy shock. The Florida Shock Anxiety Scale (FSAS) was developed to measure ICD patient shock-related anxiety. Initial psychometric evaluation revealed good reliability and validity. The purpose of this study was to examine the psychometrics of the FSAS in a large US sample of ICD patients. METHODS Participants were recruited via e-mail and the survey was completed online. Ultimately, 443 ICD patients (359 male and 421 White) completed the 10-item FSAS. RESULTS Means for FSAS were comparable to previously published data (M = 15.18, SD = 6.5). Interitem reliability was good (Cronbach's α= 0.89). The FSAS was negatively correlated with single-item measures of emotional well-being (r =-0.378, P < 0.01), sense of security (r =-0.365, P < 0.01), perceived general health (r =-0.185, P < 0.01), and quality of life (r =-0.216, P < .01), demonstrating discriminant validity. Convergent validity was supported through significant correlations with number of shocks (r = 0.464, P < 0.01) and reported disruptiveness of shock (r = 0.484, P < 0.01). Confirmatory factor analysis revealed that a single (second-order) factor model (χ(2) [34] = 75.34, P < 0.05, comparative fit index = 0.98, root mean-square error of approximation = 0.05) had the best fit. CONCLUSIONS Shock anxiety as a construct can be measured in a reliable and valid method by the FSAS. These nationally representative data suggest that a single score for shock anxiety is an easy to use and appropriate method of assessment.
Collapse
Affiliation(s)
- Jessica Ford
- Department of Psychology, East Carolina University, Greenville, North Carolina, USA
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Long-term performance of the Medtronic Sprint Fidelis lead: a matter of lead type? Europace 2012; 14:1620-3. [DOI: 10.1093/europace/eus181] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
19
|
Yang JH, Byeon K, Yim HR, Park JW, Park SJ, Huh J, Kim JS, On YK. Predictors and clinical impact of inappropriate implantable cardioverter-defibrillator shocks in Korean patients. J Korean Med Sci 2012; 27:619-24. [PMID: 22690092 PMCID: PMC3369447 DOI: 10.3346/jkms.2012.27.6.619] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 02/24/2012] [Indexed: 11/20/2022] Open
Abstract
Limited data are available on inappropriate shocks in Korean patients implanted with an implantable cardioverter-defibrillator (ICD). We investigated the impact of inappropriate shocks on clinical outcomes. This retrospective, single-center study included 148 patients treated between October 1999 and June 2011. The primary outcome was a composite event of all-cause mortality or hospitalization for any cardiac reason. The median follow-up duration was 29 months (interquartile range: 8 to 53). One or more inappropriate shocks occurred in 34 (23.0%) patients. A history of atrial fibrillation was the only independent predictor of inappropriate shock (hazard ratio [HR]: 4.16, 95% confidence interval [CI]: 1.89-9.15, P < 0.001). Atrial fibrillation was the most common cause of inappropriate shock (67.7%), followed by supraventricular tachycardia (23.5%), and abnormal sensing (8.8%). A composite event of all-cause mortality or hospitalizations for any cardiac reason during follow-up was not significantly different between patients with or without inappropriate shock (inappropriate shock vs no inappropriate shock: 35.3% vs 35.4%, adjusted HR: 1.06, 95% CI: 0.49-2.29, P = 0.877). Inappropriate shocks do not affect clinical outcomes in patients implanted with an ICD, although the incidence of inappropriate shocks is high.
Collapse
Affiliation(s)
- Jeong Hoon Yang
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyeongmin Byeon
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Ran Yim
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Wae Park
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung-Jung Park
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - June Huh
- Department of Pediatrics, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - June Soo Kim
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Keun On
- Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
20
|
BRUMBERG GENEVIEVEE, KASEER BAHAA, SHAH HEMAL, SABA SAMIR, JAIN SANDEEP. Biventricular Defibrillator Patients Have Higher Complication Rates after Revision of Recalled Leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:665-71. [DOI: 10.1111/j.1540-8159.2012.03401.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
BHATT PARAS, CURTIS JEPTHA, WANG YONGFEI, LAMPERT RACHEL. Impact of a Recent Lead Recall on Utilization of Implantable Cardioverter Defibrillators: Data from the NCDR ICD Registry™. J Cardiovasc Electrophysiol 2012; 23:861-5. [DOI: 10.1111/j.1540-8167.2012.02310.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Abstract
Background—
Approximately 268 000 Fidelis leads were implanted worldwide until distribution was suspended because of a high rate of early failure. Careful analyses of predictors of increased lead failure hazard are required to help direct future lead design and also to inform decision making on lead replacement. We sought to perform a comprehensive analysis of all potential predictors in a multicenter study.
Methods and Results—
A total of 3169 Sprint Fidelis leads were implanted in 11 centers with a total of 251 failures. Lead failure rates at 3, 4, and 5 years were 5.3%, 10.6%, and 16.8%, respectively. The rate of lead failure continues to accelerate (
P
<0.001). There were 4 independent predictors of failure: center, sex, access vein, and previous lead failure. Women had a higher hazard of failure (hazard ratio 1.51; 95% confidence interval, 1.14–2.04;
P
=0.005). Both axillary and subclavian access increased the hazard of failure (
P
=0.007); hazard ratio for axillary was 1.94, (95% confidence interval, 1.23–3.04) and for subclavian 1.63 (95% confidence interval, 1.08–2.46). Previous lead failure increased the hazard of a subsequent Fidelis failure with a hazard ratio of 3.12 (95% confidence interval, 1.80–5.41;
P
<0.001).
Conclusions—
The rate of Fidelis failure continues to increase over time, with failures approaching 17% at 5 years. Women, patients with leads inserted via the subclavian or axillary vein, and those with a previous lead fracture were at greatest risk of Fidelis failure. Our data suggest that Fidelis replacement should be strongly considered at the time of generator replacement.
Collapse
|
23
|
Tzogias L, Bellavia D, Sharma S, Donohue TJ, Schoenfeld MH. Natural history of the Sprint Fidelis lead: survival analysis from a large single-center study. J Interv Card Electrophysiol 2012; 34:37-44. [DOI: 10.1007/s10840-011-9647-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 11/14/2011] [Indexed: 11/30/2022]
|
24
|
James CA, Tichnell C, Murray B, Daly A, Sears SF, Calkins H. General and disease-specific psychosocial adjustment in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy with implantable cardioverter defibrillators: a large cohort study. ACTA ACUST UNITED AC 2012; 5:18-24. [PMID: 22238189 DOI: 10.1161/circgenetics.111.960898] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterized by frequent life-threatening ventricular arrhythmias, diagnosed on average in the teens to mid-50s and commonly treated by implantable cardioverter defibrillators (ICDs). As younger age and high frequency of ICD discharges are risk factors for difficulties in psychosocial adjustment, we developed a study to assess psychosocial adjustment among patients with ARVD/C and to determine risk factors for poor adjustment in this high-risk population. METHODS AND RESULTS Eighty-six adults enrolled in the Johns Hopkins ARVD Registry (38 male; mean age, 45.4±12.9 years), with an ICD in place for a median 3.2 years (range, 0.2 to 20.1 years), completed a set of questionnaires measuring ICD-specific anxiety (Florida Shock Anxiety Scale), device acceptance (Florida Patient Acceptance Survey), anxiety and depression (Hospital Anxiety and Depression Scale), and functional capacity (Duke Activity Status Index). Although overall device acceptance (Florida Patient Acceptance Survey mean, 76.7±15.3) was normative, patients with ARVD/C had substantially elevated body image concerns (Florida Patient Acceptance Survey subscale mean, 17.9±23.5) and device-related distress (subscale mean, 26.5±19.2), particularly among younger patients (P<0.01). Patients with ARVD/C had elevated ICD-specific (Florida Shock Anxiety Scale mean, 22.9±7.8) and general clinical anxiety (Hospital Anxiety and Depression Scale anxiety subscale mean, 6.2±3.9). Device-specific anxiety (Florida Shock Anxiety Scale) was predicted by younger age (P<0.0001), poorer functional capacity (P=0.016), having an ICD shock (P=0.003), and shorter time since ICD implant (P=0.007). Participants with poor device adjustment had an increased likelihood of clinically significant anxiety (P=0.006) and depression (P=0.008). CONCLUSIONS Patients with ARVD/C are at elevated risk for anxiety, and young patients face challenges with device acceptance. Risk factors for poor device adjustment may be used clinically to identify patients at high-risk of psychological distress.
Collapse
Affiliation(s)
- Cynthia A James
- Division of Cardiology, Department of Medicine, Johns Hopkins University, 600 N Wolfe St., Baltimore, MD 21287, USA.
| | | | | | | | | | | |
Collapse
|
25
|
VERSTEEG HENNEKE, STARRENBURG ANNEMIEKE, DENOLLET JOHAN, PALEN JOBVANDER, SEARS SAMUELF, PEDERSEN SUSANNES. Monitoring Device Acceptance in Implantable Cardioverter Defibrillator Patients Using the Florida Patient Acceptance Survey. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:283-93. [DOI: 10.1111/j.1540-8159.2011.03299.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
Habibovic M, van den Broek KC, Theuns DAMJ, Jordaens L, Alings M, van der Voort PH, Pedersen SS. Gender disparities in anxiety and quality of life in patients with an implantable cardioverter-defibrillator. Europace 2011; 13:1723-30. [DOI: 10.1093/europace/eur252] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
27
|
|
28
|
Auricchio A, Meijer A, Kurita T, Schloss E, Brinkman K, Claessens-van Ooijen M, Sterns L. Safety, efficacy, and performance of new discrimination algorithms to reduce inappropriate and unnecessary shocks: the PainFree SST clinical study design. Europace 2011; 13:1484-93. [DOI: 10.1093/europace/eur133] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
29
|
Pedersen SS, Versteeg H, Nielsen JC, Mortensen PT, Johansen JB. Patient-reported outcomes in Danish implantable cardioverter defibrillator patients with a Sprint Fidelis lead advisory notification. Europace 2011; 13:1292-8. [DOI: 10.1093/europace/eur157] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
30
|
Brouwers C, van den Broek KC, Denollet J, Pedersen SS. Gender disparities in psychological distress and quality of life among patients with an implantable cardioverter defibrillator. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 34:798-803. [PMID: 21438898 DOI: 10.1111/j.1540-8159.2011.03084.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A subset of patients with an implantable cardioverter defibrillator (ICD) reports psychological distress and poor quality of life (QoL). Gender is one of the factors that has been proposed to explain individual differences in these outcomes. In this viewpoint, we (1) review the evidence for gender disparities in psychological distress and QoL in ICD patients by means of a systematic review, and (2) provide recommendations for future research and clinical implications. A systematic search of the literature identified 18 studies with a sample size ≥ 100 that examined gender disparities in anxiety/depression and QoL in ICD patients (mean prevalence of women = 21%; mean age = 62 years). Our review shows that there is insufficient evidence to conclude that gender per se is a major autonomous predictor for disparities in psychological distress and QoL in ICD patients. Women had a higher prevalence of anxiety and poorer QoL in some studies, but there was no statistically significant gender effect in relation to 80% (26/32) of the outcomes reported in the 18 studies. Studies are warranted that are designed a priori and sufficiently powered to examine gender disparities in distress and QoL outcomes in order to establish the exact gender-specific effect. Due to a need to explore the complexity of this issue further, at this time, caution is warranted with respect to the clinical implications.
Collapse
Affiliation(s)
- Corline Brouwers
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands
| | | | | | | |
Collapse
|
31
|
HEATHERLY STEVENJ, SIMMONS TONY, FITZGERALD DAVIDM, MITCHELL MARK. Psychological Effects of Implantable Cardioverter-Defibrillator Leads under Advisory. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 34:694-9. [DOI: 10.1111/j.1540-8159.2011.03046.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|