Abstract
Recipients of implantable cardioverter-defibrillator (ICD) therapy in Western countries often experience distressful physical and psychological adjustments. Sociocultural influences on post-implant recovery are likely; however, evidence from other ethnic/cultural backgrounds is lacking. This study aimed to examine the changes in physical function and psychological distress (anxiety and depressive symptoms) from pre-implant to one, six, and 12 months post-implant in Korean patients undergoing ICD therapy. A total of 34 patients underwent pre- to post-implant longitudinal assessments of physical and psychological function using mixed modeling procedures. Physical function significantly declined from pre-implant to one month post-implant (B = −10.05, p = 0.004) and then nearly returned to the pre-implant level at six months post-implant (B = 8.34, p = 0.028). This level of improvement continued through 12 months post-implant. In psychological distress, significant improvements were observed from pre-implant to one month (anxiety (B = −1.20, p = 0.020) and in depressive symptoms (B = −1.15, p = 0.037)), which then plateaued without significant changes from one to 12 months. We concluded that physical function recovery occurred six months post-implant, but function remained poor until 12 months post-implant. Psychological distress improved one month post-implant and it was maintained. Clinicians must provide more intensive interventions to improve long-term physical function after ICD therapy.
Highlights
Implantable cardioverter-defibrillators (ICDs) for primary or secondary prevention of sudden cardiac death have proven long-term survival benefits over conventional therapeutic regimens [1,2]
Using a longitudinal study deign, repeated measurements on pre- and 1, 6, and 12 months post-implant physical and psychological distress of anxiety and depressive symptoms were conducted from newly implanted patients who underwent ICD therapy for primary or secondary prevention of sudden cardiac death
Patients experienced more physical functional limitations (40.6–69.0%) than psychological distress (10.3–20.7%) over time in this initial examination of pre- and post-implant changes in physical function and psychological distress occurring in patients with ICDs in Korea
Summary
Implantable cardioverter-defibrillators (ICDs) for primary or secondary prevention of sudden cardiac death have proven long-term survival benefits over conventional therapeutic regimens [1,2]. Their utilization in older adults (aged 70 years or older) has increased more than ever [3]. Post-implant psychological recovery seems to not occur naturally over time, while psychological distress, such as anxiety and depressive symptoms, seems to not dissipate after the ICD procedure. A minority of ICD recipients (14%) presented persistent depressive symptoms three months post-implantation [10]
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