Análisis de la calidad de vida de las personas portadoras de un desfibrilador automático implantable

Abstract

Objectives To describe possible changes in the quality of life (QL) and to identify possible differences associated to sociodemographic and clinical variables after being given an implantable cardioverter-defibrillator (ICD). Method Descriptive cross-sectional study, selecting 241 consecutive patients for a subcutaneous or subpectoral ICD implantation. One-hundred and fifty-seven patients met inclusion criteria. Introduction letter along with the assessment tool was mailed to them. Assessment tool used was the Euroqol-5D (EQ5D), validated and translated for a Spanish population. EQ5D describes health status in 5 domains: mobility (MO), self-care (SC), usual activity (UA), pain/discomfort (PD) and anxiety/depression (AD). It included a visual analogue scale (VAS) where the endpoints are labelled ‘Best imaginable health state’ and ‘Worst imaginable health state’; one before and another after ICD implantation. Results Ninety valid assessments were received: 80 males, mean age 61.2±13.1 years. Patients with EQ5D problems: MO 25 (27.7%), SC 8 (8.8%), UA 32 (35.5%), PD 22 (24.4%) and AD 29 (32.2%). Patients with ICD discharges had a higher percentage of problems in all EQ5D domains, being significant in PD and AD. Fifty four patients (60%) experienced a significant improvement in QL after ICD implant using the visual analogue scale score (75 points after vs. 50 points before; P<0.001). Conclusions The majority of ICD patients gain QL after implantation, but this gain is more limited in younger patients and those who have received discharges.