A comparison of the quality of life between patients aged below 65 years and over 65 years with Implantable Cardioverter Defibrillator (ICD)

Abstract

Purpose: The purpose of this study is to examine the actual Quality Of Life (QOL) after ICD implantation in patients who are over 65 yrs and below 65 yrs, and to explore how to provide daily life guidance appropriate for each patient's lifestyle and generation. Method: The investigation was conducted from July 2010 to July 2012. Consecutive patients who were implanted with an ICD in our hospital from April 2005 to January 2012 were enrolled. Subjective QOL after ICD implantation was assessed by interviews with SF-36 (MOS 36 Item Short-Form Health Survey) sheet and questionnaires consisting of information about the patient's clinical background, the decision-making process for ICD implantation and the life style of patients. Results: Twenty-six of the patients below 65 yrs (51.2±9.6 yrs, 17 males, 9 females) and forty-eight of the patients over 65 yrs (73.3±5.0 yrs, 40 males, 8 females) were eligible outpatients who are agreed to participate in this study. In the patients below 65 yrs, PCS (Mental Component Summary) and MCS (Mental Component Summary) fall below the national standard value of the same generation in Japan (PCS: 36.8–47.9 vs. 47.0–52.6, MCS: 40.4–49.7 vs. 47.2–49.0). In the over 65 yrs, PCS was exceeded and MCS is equivalent to national standard value in Japan (PCS: 42.9–44.9 vs. 42.6–47.6, MCS: 51.4–53.7 vs. 51.5–52.4). In the patients below 65 yrs, the MCS and PCS scores of sixteen patients who had experienced problems after ICD implantation were lower than in ten patients who had not (PCS 40.8±16.2, 49.6±14.3, MCS 42.2±15.0, 49.6±14.1; respectively). In the patients over 65 yrs, conversely, the MCS and PCS scores of sixteen patients who had experienced problems after ICD implantation were higher than the thirty-two patients who had not (PCS 39.7±12.2, 39.7±15.0, MCS 54.1±7.6, 52.1±8.5; respectively). Hobbies and hospitalization due to generator exchange had a positive effect on the PCS score in both generations. The decision-making process for ICD implantation also had a positive effect on the MCS score. Conclusion: The present study indicated that appropriate interventions that matches the patient's life style and each generation for improvement of QOL after ICD implantation. In the generation below 65 yrs, the solving of the problems in daily life contributed to high PCS and MSC score. In the generation over 65 yrs, the proactive agreement and repeated intervention that matches the life style of the patients such as hobbies is important for the QOL after ICD implantation.