The factors affecting psychological quality of life of implantable cardioverter-defibrillator patients

Abstract

Purpose: The study aimed to analyze the factors affecting the psychological quality of life of implantable cardioverter-defibrillator (ICD) patients. Methods: We investigated 214 patients from the DEF-Chiba study, which is a multi-center registry in Chiba Prefecture, Japan. All patients completed the Florida Shock Anxiety Scale (FSAS) at the time of registration. The FSAS is a tool designed to provide a quantitative measure of ICD shock-related anxiety. A stepwise multiple linear regression analysis was used to determine the important predictors of the log-transformed FSAS scores. Results: Fifty females (23%) were enrolled in this study and the mean period from implantation to registration (F/U period) was 34±30 months. Ninety-seven patients (45%) underwent an ICD implant for a primary indication and 67 patients (31%) were fllowed by remote monitoring system. Fifty-five patients (26%) had experienced shock therapy. Defibrillation threshold testing (DFT) was performed in 114 patients (53%). A female gender, experience of shock therapy, and a secondary indication were selected as predictors of ICD shock-related anxiety. However, the age, F/U period, remote monitoring system and DFT did not correlate with the FSAS score. ![Figure][1] Figure 1. Forward stepwise regression analysis Conclusions: An experience of a shock therapy is the most important determinant of psychological distress in ICD patients. For female patients who have been implanted for a secondary indication and experienced shock therapy, a fine-tuning of the device programming instead of the nominal settings should be considered after the implantation to reduce the rates of both appropriate and inappropriate shocks. [1]: pending:yes