Samuel F Sears1, Lindsey Rosman2, Shingo Sasaki3, Yusuke Kondo4, Laurence D Sterns5, Edward J Schloss6, Takashi Kurita7, Albert Meijer8, Judith Raijmakers9, Bart Gerritse9, Angelo Auricchio10. 1. Department of Psychology, East Carolina University, Greenville, North Carolina; Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina. Electronic address: SearsS@ecu.edu. 2. Department of Psychology, East Carolina University, Greenville, North Carolina; Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina. 3. Hirosaki University School of Medicine, Hirosaki, Japan. 4. Chiba University Graduate School of Medicine, Chiba, Japan. 5. Vancouver Island Arrhythmia Clinic, Victoria, British Columbia, Canada. 6. The Christ Hospital/The Ohio Heart & Vascular Center, Cincinnati, Ohio. 7. Kinki University School of Medicine, Osaka, Japan. 8. Catharina Ziekenhuis, Eindhoven, The Netherlands. 9. Medtronic Bakken Research Center, Maastricht, The Netherlands. 10. Fondazione Cardiocentro Ticino, Lugano, Switzerland.
Abstract
BACKGROUND: The effect of implantable cardioverter-defibrillator (ICD) shock on device-measured activity and patient-reported outcomes is unknown. OBJECTIVE: The purpose of this study was to analyze the acute and long-term effects of ICD shock on objective behavioral data (ie, device-based physical activity) and subjective patient-reported outcomes (eg, quality of life and shock anxiety). METHODS: The PainFree Smart Shock Technology (SST) clinical trial included 2770 patients with a single- or dual-chamber ICD or cardiac resynchronization therapy - defibrillator device who were followed for 22 ± 9 months. Participants completed measures of quality of life (EuroQol-5D [EQ-5D] questionnaire) and shock anxiety (Florida Shock Anxiety Scale) at baseline, biannual visits, and monthly for 6 months after an ICD shock. Daily physical activity data were obtained from a built-in device accelerometer. RESULTS: The average daily activity was 185.3 ± 119.4 min/d. Activity was significantly reduced after an ICD shock (P < .0001) and recovered to a normal level after ∼90 days. An ICD shock was also associated with decreased quality of life (EQ5-D health score) and increased EQ-5D anxiety scores, but it did not affect mobility, self-care, activity, or pain. Similarly, shock anxiety (Florida Shock Anxiety Scale) increased in shocked patients and remained significantly elevated at 24 months, regardless of appropriate or inappropriate shock delivery. CONCLUSION: ICD shocks have a long-lasting adverse effect on both objective, device-measured physical activity and subjective patient-reported outcomes of quality of life and shock anxiety. Successful management of patients with an ICD requires attention to clinically relevant behavioral and psychological outcomes to expedite recovery and return to activities of daily living.
BACKGROUND: The effect of implantable cardioverter-defibrillator (ICD) shock on device-measured activity and patient-reported outcomes is unknown. OBJECTIVE: The purpose of this study was to analyze the acute and long-term effects of ICD shock on objective behavioral data (ie, device-based physical activity) and subjective patient-reported outcomes (eg, quality of life and shock anxiety). METHODS: The PainFree Smart Shock Technology (SST) clinical trial included 2770 patients with a single- or dual-chamber ICD or cardiac resynchronization therapy - defibrillator device who were followed for 22 ± 9 months. Participants completed measures of quality of life (EuroQol-5D [EQ-5D] questionnaire) and shock anxiety (Florida Shock Anxiety Scale) at baseline, biannual visits, and monthly for 6 months after an ICD shock. Daily physical activity data were obtained from a built-in device accelerometer. RESULTS: The average daily activity was 185.3 ± 119.4 min/d. Activity was significantly reduced after an ICD shock (P < .0001) and recovered to a normal level after ∼90 days. An ICD shock was also associated with decreased quality of life (EQ5-D health score) and increased EQ-5D anxiety scores, but it did not affect mobility, self-care, activity, or pain. Similarly, shock anxiety (Florida Shock Anxiety Scale) increased in shocked patients and remained significantly elevated at 24 months, regardless of appropriate or inappropriate shock delivery. CONCLUSION: ICD shocks have a long-lasting adverse effect on both objective, device-measured physical activity and subjective patient-reported outcomes of quality of life and shock anxiety. Successful management of patients with an ICD requires attention to clinically relevant behavioral and psychological outcomes to expedite recovery and return to activities of daily living.
Authors: Clifford G Robinson; Pamela P Samson; Kaitlin M S Moore; Geoffrey D Hugo; Nels Knutson; Sasa Mutic; S Murty Goddu; Adam Lang; Daniel H Cooper; Mitchell Faddis; Amit Noheria; Timothy W Smith; Pamela K Woodard; Robert J Gropler; Dennis E Hallahan; Yoram Rudy; Phillip S Cuculich Journal: Circulation Date: 2019-01-15 Impact factor: 29.690
Authors: Mehmet K Aktaş; Arwa Younis; Wojciech Zareba; Valentina Kutyifa; Helmut Klein; James P Daubert; Mark Estes; Scott McNitt; Bronislava Polonsky; Ilan Goldenberg Journal: J Am Coll Cardiol Date: 2021-05-25 Impact factor: 27.203
Authors: Yitschak Biton; Usama A Daimee; Jayson R Baman; Valentina Kutyifa; Scott McNitt; Bronislava Polonsky; Wojciech Zareba; Ilan Goldenberg Journal: J Am Heart Assoc Date: 2019-03-19 Impact factor: 5.501