Information provision, satisfaction and emotional distress in patients with an implantable cardioverter-defibrillator

Abstract

The implantable cardioverter-defibrillator (ICD) is the treatment of choice for primary and secondary prevention of sudden cardiac death due to ventricular arrhythmias [ 1 Moss A. Hall W. Cannom D. et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996; 335: 1933-1940 Crossref PubMed Scopus (3569) Google Scholar , 2 Bardy G.H. Lee K.L. Mark D.B. et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005; 352: 225-237 Crossref PubMed Scopus (5302) Google Scholar , 3 The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med. 1997; 337: 1576-1584 Crossref PubMed Scopus (3004) Google Scholar ]. Although the majority of patients adapts well to living with an ICD, 1 in 4 patients report anxiety and depression [ [4] Sears S.F. Conti J.B. Quality of life and psychological functioning of ICD patients. Heart. 2002; 87: 488-493 Crossref PubMed Google Scholar ]. Sufficient understanding of the reasons for ICD implantation, its benefits, side effects, and impact on daily life plays a major role in adaptation. Adequate information provision and psycho-education may facilitate adaptation and reduce emotional distress [ 5 Vazquez L.D. Conti J.B. Sears S.F. Female-specific education, management, and lifestyle enhancement for implantable cardioverter defibrillator patients: the FEMALE-ICD study. Pacing Clin Electrophysiol. 2010; 33: 1131-1140 Crossref PubMed Scopus (38) Google Scholar , 6 Dunbar S.B. Dougherty C.M. Sears S.F. et al. Educational and psychological interventions to improve outcomes for recipients of implantable cardioverter defibrillators and their families: a scientific statement from the American Heart Association. Circulation. 2012; 126: 2146-2172 Crossref PubMed Scopus (158) Google Scholar , 7 Dunbar S.B. Langberg J.J. Reilly C.M. et al. Effect of a psychoeducational intervention on depression, anxiety, and health resource use in implantable cardioverter defibrillator patients. Pacing Clin Electrophysiol. 2009; 32: 1259-1271 Crossref PubMed Scopus (81) Google Scholar , 8 Eads A.S. Sears S.F.J. Sotile W.M. Conti J.B. Supportive communication with implantable cardioverter defibrillator patients: seven principles to facilitate psychosocial adjustment. J Cardiopulm Rehabil Prev. 2000; 20: 109-114 Crossref Scopus (22) Google Scholar ]. Paradoxically, recent surveys indicate that many patients have insufficient knowledge about their ICD and associated challenges [ 9 Cinar F.I. Tosun N. Kose S. Evaluation of an education and follow-up programme for implantable cardioverter defibrillator-implanted patients. J Clin Nurs. 2013; 22: 2474-2486 Crossref PubMed Scopus (15) Google Scholar , 10 Groarke J. Beirne A. Buckley U.N.A. et al. Deficiencies in patients' comprehension of implantable cardioverter defibrillator therapy. Pacing Clin Electrophysiol. 2012; 35: 1097-1102 Crossref PubMed Scopus (23) Google Scholar ].