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

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Summary

Introduction

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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