Ingela Thylén1, Rebecca L Dekker2, Tiny Jaarsma3, Anna Strömberg4, Debra K Moser5. 1. Department of Cardiology and Department of Medicine and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden. Electronic address: ingela.thylen@lio.se. 2. College of Nursing, University of Kentucky, Lexington, United States. Electronic address: rebecca.dekker@uky.edu. 3. Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden. Electronic address: tiny.jaarsma@liu.se. 4. Department of Cardiology and Department of Medicine and Health Sciences, Division of Nursing Sciences, Linköping University, Linköping, Sweden. Electronic address: anna.stromberg@liu.se. 5. College of Nursing, University of Kentucky, Lexington, United States. Electronic address: dmoser@email.uky.edu.
Abstract
OBJECTIVE: Although most patients with implantable cardioverter defibrillators (ICDs) adjust well, some have considerable psychological distress. Factors associated with psychological adjustment in ICD-recipients are still not well understood. Our purpose was to describe quality-of-life (QoL) and prevalence of self-reported symptoms of anxiety and depression in a large national cohort of ICD-recipients, and to determine socio-demographic, clinical, and ICD-related factors associated with these variables. METHODS: A cross-sectional, correlational design was used. All eligible adult ICD-recipients in the Swedish ICD- and Pacemaker Registry were invited to participate. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), and QoL with the EuroQol-5D. RESULTS: A total of 3067 ICD-recipients (66±11years, 80% male) were included. The mean HADS score was 3.84±3.70 for anxiety symptoms and 2.99±3.01 for symptoms of depression. The mean EQ-5D index score was 0.82±0.21. The probability of symptoms of anxiety and depression was associated with younger age, living alone, and a previous history of myocardial infarction or heart failure. Additionally, female ICD-recipients had a higher probability of symptoms of anxiety. A higher level of ICD-related concerns was most prominently related to symptoms of anxiety, depressive symptoms and poorer QoL, while number of shocks, ICD-indication and time since implantation were not independently related. CONCLUSIONS: In this large cohort of ICD-recipients, the association of ICD-related concerns with symptoms of anxiety, depressive symptoms, and poor QoL suggests that ICD specific factors should be addressed in order to improve outcomes.
OBJECTIVE: Although most patients with implantable cardioverter defibrillators (ICDs) adjust well, some have considerable psychological distress. Factors associated with psychological adjustment in ICD-recipients are still not well understood. Our purpose was to describe quality-of-life (QoL) and prevalence of self-reported symptoms of anxiety and depression in a large national cohort of ICD-recipients, and to determine socio-demographic, clinical, and ICD-related factors associated with these variables. METHODS: A cross-sectional, correlational design was used. All eligible adult ICD-recipients in the Swedish ICD- and Pacemaker Registry were invited to participate. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), and QoL with the EuroQol-5D. RESULTS: A total of 3067 ICD-recipients (66±11years, 80% male) were included. The mean HADS score was 3.84±3.70 for anxiety symptoms and 2.99±3.01 for symptoms of depression. The mean EQ-5D index score was 0.82±0.21. The probability of symptoms of anxiety and depression was associated with younger age, living alone, and a previous history of myocardial infarction or heart failure. Additionally, female ICD-recipients had a higher probability of symptoms of anxiety. A higher level of ICD-related concerns was most prominently related to symptoms of anxiety, depressive symptoms and poorer QoL, while number of shocks, ICD-indication and time since implantation were not independently related. CONCLUSIONS: In this large cohort of ICD-recipients, the association of ICD-related concerns with symptoms of anxiety, depressive symptoms, and poor QoL suggests that ICD specific factors should be addressed in order to improve outcomes.
Authors: Ammar M Killu; Niyada Naksuk; Zdeněk Stárek; Christopher V DeSimone; Faisal F Syed; Prakriti Gaba; Jiří Wolf; Frantisek Lehar; Martin Pesl; Pavel Leinveber; Michal Crha; Dorothy Ladewig; Joanne Powers; Scott Suddendorf; David O Hodge; Gaurav Satam; Miroslav Novák; Tomas Kara; Charles J Bruce; Paul A Friedman; Samuel J Asirvatham Journal: JACC Clin Electrophysiol Date: 2017-07
Authors: Adam Viktorisson; Katharina S Sunnerhagen; Ulrika Pöder; Johan Herlitz; Åsa B Axelsson Journal: BMJ Open Date: 2018-06-06 Impact factor: 2.692