Henneke Versteeg1, Ivy Timmermans2, Mathias Meine3, Edgar Zitron4, Philippe Mabo5, Johan Denollet6. 1. Department of Cardiology, University Medical Center Utrecht, The Netherlands. Electronic address: h.versteeg-4@umcutrecht.nl. 2. Department of Cardiology, University Medical Center Utrecht, The Netherlands; CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands. 3. Department of Cardiology, University Medical Center Utrecht, The Netherlands. 4. Department of Cardiology, Medical University Hospital Heidelberg, Germany. 5. Service de Cardiologie, Centre Hospitalier Universitaire de Rennes, France. 6. CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
Abstract
BACKGROUND: Evidence on psychological distress in patients living with an implantable cardioverter defibrillator (ICD) is inconclusive. The current study is the first to examine the prevalence and risk markers of anxiety and/or depression in a large international cohort of European ICD patients with or without cardiac resynchronization therapy (CRT). METHOD: Heart failure patients (N=569) from France, Germany, Spain, Switzerland and the Netherlands participating in the REMOTE-CIED study completed a set of questionnaires 1-2weeks post ICD-implantation, including the 7-item Generalized Anxiety Disorder scale and the 9-item Patient Health Questionnaire to assess anxiety and depressive symptoms, respectively. Patients' clinical data were obtained from their medical records. RESULTS: The prevalence of anxiety was 16% and that of depression 19%, with 25% of patients reporting one or both types of distress. Multivariable logistic regression analysis showed that age <60years (odds ratio (OR)=2.5[95% confidence interval=1.2-5.0]), having a threatening view of heart failure (OR=4.7[2.7-8.2]), a high level of ICD-related concerns (OR=2.9[1.7-5.1]), Type D personality (OR=2.4[1.3-4.4]), poor patient-reported health status (OR=2.2[1.3-3.9]) and receiving psychotropic medication (OR=3.0[1.5-5.9]) were positively associated with distress, while attending cardiac rehabilitation (OR=0.3[0.2-0.7]) was negatively associated with distress. CONCLUSIONS: A significant subset of European ICD and CRT-defibrillator patients reports anxiety and/or depression in the first weeks post implantation. Patients' psychological characteristics, especially negative perceptions about their illness and treatment, were the strongest associates of distress. Timely identification of these patients is essential as they may benefit from psychological interventions and cardiac rehabilitation in terms of improved quality of life and prognosis.
BACKGROUND: Evidence on psychological distress in patients living with an implantable cardioverter defibrillator (ICD) is inconclusive. The current study is the first to examine the prevalence and risk markers of anxiety and/or depression in a large international cohort of European ICDpatients with or without cardiac resynchronization therapy (CRT). METHOD:Heart failurepatients (N=569) from France, Germany, Spain, Switzerland and the Netherlands participating in the REMOTE-CIED study completed a set of questionnaires 1-2weeks post ICD-implantation, including the 7-item Generalized Anxiety Disorder scale and the 9-item Patient Health Questionnaire to assess anxiety and depressive symptoms, respectively. Patients' clinical data were obtained from their medical records. RESULTS: The prevalence of anxiety was 16% and that of depression 19%, with 25% of patients reporting one or both types of distress. Multivariable logistic regression analysis showed that age <60years (odds ratio (OR)=2.5[95% confidence interval=1.2-5.0]), having a threatening view of heart failure (OR=4.7[2.7-8.2]), a high level of ICD-related concerns (OR=2.9[1.7-5.1]), Type D personality (OR=2.4[1.3-4.4]), poor patient-reported health status (OR=2.2[1.3-3.9]) and receiving psychotropic medication (OR=3.0[1.5-5.9]) were positively associated with distress, while attending cardiac rehabilitation (OR=0.3[0.2-0.7]) was negatively associated with distress. CONCLUSIONS: A significant subset of European ICD and CRT-defibrillator patients reports anxiety and/or depression in the first weeks post implantation. Patients' psychological characteristics, especially negative perceptions about their illness and treatment, were the strongest associates of distress. Timely identification of these patients is essential as they may benefit from psychological interventions and cardiac rehabilitation in terms of improved quality of life and prognosis.
Authors: Ivy Timmermans; Mathias Meine; Istvan Szendey; Johannes Aring; Javier Romero Roldán; Lieselotte van Erven; Philipp Kahlert; Edgar Zitron; Philippe Mabo; Johan Denollet; Henneke Versteeg Journal: Pacing Clin Electrophysiol Date: 2019-01-02 Impact factor: 1.976
Authors: Lieke M van den Heuvel; Tanya Sarina; Joanna Sweeting; Laura Yeates; Kezia Bates; Catherine Spinks; Catherine O'Donnell; Samuel F Sears; Kevin McGeechan; Christopher Semsarian; Jodie Ingles Journal: Heart Rhythm O2 Date: 2022-02-08