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Dhande M, Myaskovsky L, Althouse A, Singh M, Weiss R, Shalaby A, Al-Khatib SM, Topoll A, Jain S, Saba S. Quality of Life and Type of Cardiac Resynchronization Therapy Device in Older Heart Failure Patients. J Palliat Med 2023; 26:481-488. [PMID: 36350362 PMCID: PMC10066768 DOI: 10.1089/jpm.2022.0217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/11/2022] Open
Abstract
Background: Cardiac resynchronization therapy (CRT) improves quality of life (QOL) in heart failure (HF) patients with reduced ejection fraction. Clinicians may have difficulty choosing between CRT with a pacemaker (CRT-P) or a defibrillator (CRT-D) for older patients. CRT-P devices are smaller, have more battery longevity, are less prone to erosions or recalls, and do not deliver shocks. These factors may impact patients' QOL, but data on such comparisons are lacking. Objectives: We examined the impact of CRT-P versus CRT-D on the QOL of older (≥75 years) HF patients who qualified for implantable cardioverter defibrillator therapy. Settings/Subjects/Measurements: We enrolled 101 CRT recipients and assessed QOL at baseline and at six-month post-implant using the Short Form Health Survey (SF-36) and the Minnesota living with heart failure (MLHF) questionnaires. Results: The average age of enrolled patients was 81 years, 27% were women, and 40 received a CRT-P device. After adjusting for baseline QOL score, age, sex, HF functional class, and the occurrence of adverse events, we found no significant differences in QOL outcomes between CRT-P and CRT-D recipients based on either the subscales or the composite scores for the SF-36 or MLHF questionnaires at six-months post-implantation. Conclusions: Older CRT-P and CRT-D recipients report comparable QOL scores six months after device implantation. Larger cohort studies with longer follow-up are needed to accurately assess potential QOL differences between CRT-D and CRT-P recipients to guide clinical decision making and ensure the right balance of risk versus benefit in these patients. Appropriate goals-of-care discussions are the corner stone of clinical decision making regarding defibrillator therapy. As such, even as the data stand at present, there is a need for more deliberate referral of older patients with HF to Palliative Care Specialists, or to Cardiologists trained in Palliative Care Medicine. clinicaltrials.gov listing: NCT03031847.
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Affiliation(s)
- Mehak Dhande
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Larissa Myaskovsky
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Andrew Althouse
- Department of Medicine, Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Madhurmeet Singh
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Raul Weiss
- Department of Medicine, Division of Cardiology, Ohio State University, Columbus, USA
| | - Alaa Shalaby
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Medicine, Division of Cardiology, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Sana M. Al-Khatib
- Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Alicia Topoll
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Medicine, Division of Palliative Care, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Sandeep Jain
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Samir Saba
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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2
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Saxena S, Goldenberg I, McNitt S, Hsich E, Kutyifa V, Bragazzi NL, Polonsky B, Aktas MK, Huang DT, Rosero S, Klein H, Zareba W, Younis A. Sex Differences in the Risk of First and Recurrent Ventricular Tachyarrhythmias Among Patients Receiving an Implantable Cardioverter-Defibrillator for Primary Prevention. JAMA Netw Open 2022; 5:e2217153. [PMID: 35699956 PMCID: PMC9198764 DOI: 10.1001/jamanetworkopen.2022.17153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/18/2022] [Indexed: 11/14/2022] Open
Abstract
Importance Current guidelines for primary implantable cardioverter-defibrillator (ICD) therapy do not account for sex differences in arrhythmic risk in ICD candidates. Objective To evaluate the association between sex and risk of ventricular tachyarrhythmia (VTA) and mortality. Design, Setting, and Participants This cohort study compared differences in the risk of VTA and mortality between 4506 men and women enrolled in the 4 Multicenter Automatic Defibrillator Implantation Trials (MADIT) between July 1, 1997, and December 31, 2011. Data from prospective randomized controlled multicenter studies were analyzed retrospectively. Men and women with an ICD or cardiac resynchronization therapy defibrillator who were enrolled in all MADIT studies were included. Data were analyzed between January 10 and June 10, 2021. Exposures ICD implant. Main Outcomes and Measures The primary end point was sustained VTA, defined as ICD-recorded, treated or monitored VTA at least 170/min or ventricular fibrillation. Secondary VTA end points included VTA at least 200/min, appropriate ICD shocks, and appropriate antitachycardia pacing. All end points were included in a first and recurrent event analysis. Results Of the 4506 study participants, 3431 were men (76%). Mean (SD) age of the cohort was 64 (12) years. For women vs men, the mean (SD) age (64 [12] years vs 64 [11] years) and left ventricular ejection fraction (24% vs 25%) were similar, but women exhibited a higher frequency of nonischemic cardiomyopathy (454 of 1075 women [42%] vs 2535 of 3431 men [74%]). Women had significantly lower 3-year cumulative probability of sustained VTA (16% vs 26%), fast VTA (9% vs 17%), and appropriate ICD shocks (7% vs 15%) compared with men (P < .001 for all). Multivariable analysis showed that female sex was independently associated with at least 40% lower risk of all first and recurrent VTA end points (P < .001 for all), including the primary end point (first event, HR = 60 [95% CI, 50-73], P < .001; recurrent event, HR = 49 [95% CI, 43-55], P < .001), after accounting for the competing risk of all-cause mortality and nonarrhythmic mortality. The lower VTA risk associated with female sex was consistent in risk subsets but was significantly more pronounced in patients with nonischemic cardiomyopathy (female vs male in the ischemic group: hazard ratio, 0.73 [95% CI, 0.56-0.95], P = .02; nonischemic group: hazard ratio, 0.50 [95% CI, 0.38-0.66], P < .001; P = .03 for interaction between female sex and cardiomyopathy). Conclusions and Relevance Findings suggest that women display a significantly lower risk of first and recurrent life-threatening VTA events than men, and that it is more pronounced in patients with nonischemic cardiomyopathy, suggesting a need for sex-specific risk assessment for primary prevention ICD therapy.
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Affiliation(s)
- Shireen Saxena
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Ilan Goldenberg
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Scott McNitt
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Eileen Hsich
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Valentina Kutyifa
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Center for Disease Modeling, York University, Toronto, Ontario, Canada
| | - Bronislava Polonsky
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Mehmet K. Aktas
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - David T. Huang
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Spencer Rosero
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Helmut Klein
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Wojciech Zareba
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
| | - Arwa Younis
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
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3
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Wilson DG, Brewster N, Taylor RJ, Trevelyan A, Apostolakis M, Goyal D, Foster W, Walklet E, Bradley E. Pain during cardiac implantable electronic device implantation. THE BRITISH JOURNAL OF CARDIOLOGY 2021; 28:43. [PMID: 35747068 PMCID: PMC9063704 DOI: 10.5837/bjc.2021.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In order to evaluate the extent and causes of pain during cardiac implantable electronic device (CIED) implantation in our hospital, a prospective audit over a 23-month period using a patient selfreporting questionnaire was undertaken. In total, 599 procedures were reported, 52.9% for de novo pacemaker implantation and 23.4% for high-energy devices (cardiac resynchronisation therapy defibrillator [CRT-D], implantable cardiac defibrillator [ICD], subcutaneous ICD). Overall, the median pain score was 2/10 (interquartile range 2-4). In total, 61.6% (367/599) reported no pain or mild pain (pain scores 0-3/10), 27.7% (165/599) reported moderate pain (pain score of 4-6/10) and 10.7% (64/599) reported severe pain (pain score of 7-10/10) during the procedure. Significant preimplant worry (odds ratio [OR] 2.13, 95% confidence interval [CI] 1.22 to 3.73) and higher lidocaine doses (OR 1.06, 95%CI 1.00 to 1.11) were associated with severe patient-reported pain. In conclusion, most patients underwent CIED implantation with minimum stress and maximum comfort. An important minority reported severe pain during the procedure. Optimising surgical technique and interventions targeted at reducing pre- and peri-implant worry, particularly in women, and especially in those receiving ICDs, warrants further investigation to reduce patient-reported pain during CIED implantation.
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Affiliation(s)
| | - Nicki Brewster
- Arrhythmia Specialist Nurse Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD
| | - Robin J Taylor
- Consultant Cardiologist Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD
| | - Amelia Trevelyan
- Medical Student Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD
| | - Michail Apostolakis
- Consultant Cardiologist Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD
| | - Deepak Goyal
- Consultant Cardiologist Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD
| | - Will Foster
- Consultant Cardiologist Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, WR5 1DD
| | - Elaine Walklet
- Senior Lecturer in Psychology School of Natural and Social Sciences, Francis Close Hall Campus, University of Gloucestershire, Swindon Road, Cheltenham, Gloucestershire, GL50 4AZ
| | - Eleanor Bradley
- Professor of Health Psychology, College Director of Research and Knowledge Exchange, College of Health, Life and Environmental Sciences University of Worcester, Henwick Grove, St. John’s, Worcester, WR2 6AJ
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4
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Canterbury A, Saba S. Cardiac resynchronization therapy using a pacemaker or a defibrillator: Patient selection and evidence to support it. Prog Cardiovasc Dis 2021; 66:46-52. [PMID: 33865865 DOI: 10.1016/j.pcad.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
Cardiac resynchronization therapy (CRT) is an established treatment for patients with heart failure (HF), myocardial dysfunction and prolonged ventricular depolarization on surface electrocardiogram. CRT can be delivered by a pacemaker (CRT-P) or a combined pacemaker-defibrillator (CRT-D). Although these two types of devices are very different in size, function, and cost, current published guidelines do not distinguish between them, leaving the choice of which device to implant to the treating physician and the informed patient. In this paper, we review the published CRT clinical trial literature with focus on the outcomes of HF patients treated with CRT-P versus CRT-D. We also attempt to provide guidance as to the appropriate choice of CRT device type, in the absence of randomized prospective trials geared to answer this specific question.
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Affiliation(s)
- Ann Canterbury
- Heart and Vascular Institute at the University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America
| | - Samir Saba
- Heart and Vascular Institute at the University of Pittsburgh Medical Center, Pittsburgh, PA, United States of America.
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5
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Hussaini S, Venkatesan V, Biasci V, Romero Sepúlveda JM, Quiñonez Uribe RA, Sacconi L, Bub G, Richter C, Krinski V, Parlitz U, Majumder R, Luther S. Drift and termination of spiral waves in optogenetically modified cardiac tissue at sub-threshold illumination. eLife 2021; 10:59954. [PMID: 33502313 PMCID: PMC7840178 DOI: 10.7554/elife.59954] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/28/2020] [Indexed: 01/01/2023] Open
Abstract
The development of new approaches to control cardiac arrhythmias requires a deep understanding of spiral wave dynamics. Optogenetics offers new possibilities for this. Preliminary experiments show that sub-threshold illumination affects electrical wave propagation in the mouse heart. However, a systematic exploration of these effects is technically challenging. Here, we use state-of-the-art computer models to study the dynamic control of spiral waves in a two-dimensional model of the adult mouse ventricle, using stationary and non-stationary patterns of sub-threshold illumination. Our results indicate a light-intensity-dependent increase in cellular resting membrane potentials, which together with diffusive cell-cell coupling leads to the development of spatial voltage gradients over differently illuminated areas. A spiral wave drifts along the positive gradient. These gradients can be strategically applied to ensure drift-induced termination of a spiral wave, both in optogenetics and in conventional methods of electrical defibrillation.
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Affiliation(s)
- Sayedeh Hussaini
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,Institute for the Dynamics of Complex Systems, Goettingen University, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany
| | - Vishalini Venkatesan
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,University Medical Center Goettingen, Clinic of Cardiology and Pneumology, Goettingen, Germany
| | - Valentina Biasci
- European Laboratory for Non-Linear Spectroscopy, Sesto Fiorentino (FI), Italy.,Division of Physiology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Raul A Quiñonez Uribe
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany
| | - Leonardo Sacconi
- European Laboratory for Non-Linear Spectroscopy, Sesto Fiorentino (FI), Italy.,Institute for Experimental Cardiovascular Medicine, University of Freiburg, Freiburg, Germany.,National Institute of Optics, National Research Council, Florence, Italy
| | - Gil Bub
- Department of Physiology, MGill University, Montreal, Canada
| | - Claudia Richter
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany.,University Medical Center Goettingen, Clinic of Cardiology and Pneumology, Goettingen, Germany
| | - Valentin Krinski
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany.,INPHYNI, CNRS, Sophia Antipolis, Paris, France
| | - Ulrich Parlitz
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,Institute for the Dynamics of Complex Systems, Goettingen University, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany
| | - Rupamanjari Majumder
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany
| | - Stefan Luther
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Goettingen, Germany.,Institute for the Dynamics of Complex Systems, Goettingen University, Goettingen, Germany.,German Center for Cardiovascular Research, Partner Site Goettingen, Goettingen, Germany.,University Medical Center Goettingen, Institute of Pharmacology and Toxicology, Goettingen, Germany
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6
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Carroll AJ, Christon LM, Rodrigue JR, Fava JL, Frisch MB, Serber ER. Implementation, feasibility, and acceptability of quality of life therapy to improve positive emotions among patients with implantable cardioverter defibrillators. J Behav Med 2020; 43:968-978. [PMID: 32285238 PMCID: PMC7554076 DOI: 10.1007/s10865-020-00153-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
Implantable cardioverter defibrillators (ICDs) save lives, but often induce significant psychological distress among patients. Positive psychological constructs are associated with improved outcomes among cardiac patients. In this NHLBI-funded randomized controlled trial, one aim was to evaluate the feasibility and acceptability of a positive psychology intervention (Quality of Life Therapy; QOLT, n = 11), compared to a Heart Healthy Education (HHE) control (n = 10), among ICD patients. A majority of participants across groups attended all 12 sessions (71%) and completed homework assignments (80%). Agreement on participant engagement and interventionist protocol adherence were high, with no differences between groups (ps > 0.20). A greater proportion of QOLT participants rated their sessions was "very" helpful compared to HHE participants (63% vs. 10%, p = 0.19). These initial data support the feasibility and acceptability of QOLT. A larger-scale trial using positive psychology interventions among ICD patients is indicated to determine potential mechanisms underlying the relationship between positive psychological constructs and cardiovascular health.
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Affiliation(s)
- Allison J Carroll
- Division of Bio-Behavioral Medicine, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC, 29425, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lillian M Christon
- Division of Bio-Behavioral Medicine, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC, 29425, USA
| | - James R Rodrigue
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Joseph L Fava
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | | | - Eva R Serber
- Division of Bio-Behavioral Medicine, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC, 29425, USA.
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7
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Meuret AE, Tunnell N, Roque A. Anxiety Disorders and Medical Comorbidity: Treatment Implications. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:237-261. [PMID: 32002933 DOI: 10.1007/978-981-32-9705-0_15] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Anxiety disorders are debilitating psychological disorders characterized by a wide range of cognitive and somatic symptoms. Anxiety sufferers have a higher lifetime prevalence of various medical problems. Chronic medical conditions furthermore increase the likelihood of psychiatric disorders and overall dysfunction. Lifetime rates of cardiovascular, respiratory, gastrointestinal, and other medical problems are disproportionately high in anxiety and panic/fear sufferers. The heightened comorbidity is not surprising as many symptoms of anxiety and panic/fear mimic symptoms of medical conditions. Panic disorder specifically is strongly linked to medical conditions due to its salient somatic symptoms, such as dyspnea, dizziness, numbness, chest pain, and heart palpitations, all of which can signal danger and deterioration for chronic disease sufferers. This chapter identifies shared correlates of medical illness and anxiety disorders and evidence for misinterpretation of symptoms as medically relevant and offers an analysis of implications for treatment of both types of conditions. We will concentrate on medical conditions with high associations for anxiety and panic by aspects of symptomatology, specifically neurological disorders (fibromyalgia, epilepsy, cerebral palsy), diabetes, gastrointestinal illness (irritable bowel syndrome, gastroesophageal reflux disease), and cardiovascular and respiratory illnesses (asthma).
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Affiliation(s)
- Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
| | - Natalie Tunnell
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Andres Roque
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
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8
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Ichikura K, Kobayashi S, Matsuoka S, Suzuki T, Nishimura K, Shiga T, Hagiwara N, Ishigooka J, Suzuki SI. Avoidance behavior associated with depressive symptoms in patients with implantable cardioverter defibrillators. Int J Clin Health Psychol 2017; 17:1-8. [PMID: 30487875 PMCID: PMC6236320 DOI: 10.1016/j.ijchp.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/09/2016] [Indexed: 11/12/2022] Open
Abstract
Objective: Many patients with implantable cardioverter defibrillators experience depressive symptoms. In addition, avoidance behavior is a common problem among patients with implantable cardioverter defibrillators. We examined the association between avoidance behaviors and depressive symptoms in patients with implantable cardioverter defibrillators. Method: We conducted a single-center, cross-sectional study with self-completed questionnaires between May 2010 and March 2011. We measured avoidance behaviors (avoidance of places, avoidance of objects, and avoidance of situations) and depressive symptoms (using the Beck Depression Inventory, Version II) in 119 participants. An avoidance behaviors instrument was developed for this study and we confirmed its internal consistency reliability. Results: Ninety-two (77.3%) patients were aged older than 50 years, and 86 (72.3%) were men. Fifty-one (42.9%) patients reported "avoidance of places", 34 (28.6%) reported "avoidance of objects", and 63 (52.9%) reported "avoidance of activity". Avoidance behavior was associated with increased odds for the presence of depressive symptoms (OR 1.31; 95% CI 1.06-1.62). Conclusions: This was the first study to identify the relationship between avoidance behavior and depressive symptoms among patients with implantable cardioverter defibrillators; however, there are a few methodological limitations.
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Affiliation(s)
- Kanako Ichikura
- Waseda University, Japan
- Tokyo Medical and Dental University, Japan
| | - Sayaka Kobayashi
- Tokyo Women's Medical University, Japan
- Saitama Medical University, Japan
| | - Shiho Matsuoka
- Waseda University, Japan
- Tokyo Medical and Dental University, Japan
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SAITO NAO, TARU CHIEMI, MIYAWAKI IKUKO. Time-Dependent Changes in Psychosocial Distress in Japanese Patients with Implantable Cardioverter Defibrillators. THE KOBE JOURNAL OF MEDICAL SCIENCES 2016; 62:E99-E106. [PMID: 28239075 PMCID: PMC5432064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 09/05/2016] [Indexed: 06/06/2023]
Abstract
This prospective study clarified changes in the mood states of Japanese patients with implantable cardioverter defibrillators as well as factors related to the mood states. Using a longitudinal repeated-measure design, 29 patients with implantable cardioverter defibrillators completed the Profile of Mood States-Short Form Japanese Version questionnaire before discharge and 1, 4, 7, and 13 months after implantation. One month after discharge, the mood states of the patients with implantable cardioverter defibrillators improved. From 7 to 13 months after discharge, moods deteriorated; 13 months after discharge, moods were equivalent to those at the time of discharge. No relationship with defibrillation experience was detected in this study, but employment, age, sex, and lack of experience of syncopal attack were factors related to poor mood states for patients with implantable cardioverter defibrillators. Therefore, Japanese patients with implantable cardioverter defibrillators with any factor deteriorating their mood state should be monitored so that their mood state does not deteriorate again between six months and one year after implantation.
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Affiliation(s)
- NAO SAITO
- Department of Nursing, Faculty of Health Sciences Graduate School of Health Sciences, Kobe University
| | - CHIEMI TARU
- Department of Nursing, Faculty of Health Sciences Graduate School of Health Sciences, Kobe University
| | - IKUKO MIYAWAKI
- Department of Nursing, Faculty of Health Sciences Graduate School of Health Sciences, Kobe University
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