Jennifer L Miller1, Ingela Thylén2, Samy C Elayi3, Farshid Etaee4, Steve Fleming5, Mary M Czarapata6, Terry A Lennie1, Debra K Moser1. 1. University of Kentucky College of Nursing, RICH Heart Program, Lexington, KY, United States. 2. Department of Cardiology, Department of Medical Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden. 3. University of Florida, Jacksonville, FL, United States. 4. Division of Cardiology, University of Kentucky College of Medicine, Gill Heart Institute, 800 Rose St, Lexington, KY 40536, United States. Electronic address: dr.farshid.etaee@gmail.com. 5. University of Kentucky College of Public Health, Lexington, KY, United States. 6. Division of Cardiology, University of Kentucky College of Medicine, Gill Heart Institute, 800 Rose St, Lexington, KY 40536, United States.
Abstract
BACKGROUND: The prevalence of multi-morbidity in implantable cardioverter defibrillator (ICD) recipients is approximately 25%. Multi-morbidity is associated with poor health and psychological outcomes in this population and may affect ICD recipients' quality-of-life (QOL). The purpose of this study was to determine the prevalence of psychological distress (anxiety, depressive symptoms, and Type-D personality) in ICD recipients with varying levels of comorbidities, and to examine the association between multi-morbidity burden and QOL in this population. METHODS: All adults listed in the Swedish ICD and Pacemaker Registry in 2012 with an ICD implanted for at least one year were invited to participate in this study. Binary logistic regression was used to predict QOL using the EQ-5D mean index dichotomized based on median QOL scores. Multi-morbidity burden scores were based on quartile groupings. RESULTS: A total of 2658 ICD recipients participated in the study (with a mean age of 65, 20.6% female, mean implant duration of 4.7 years, with 35.4% implanted for primary prevention of sudden cardiac arrest). Greater multi-morbidity burden, female sex, not working outside the home, history of ICD shock, negative ICD experience, higher levels of ICD-related concerns, and the presence of anxiety, depression, or Type D personality were associated with worse QOL in ICD recipients. Predictors differed by multi-morbidity burden level. CONCLUSIONS: Multi-morbidity burden and psychological distress is an essential factor related to QOL. This issue should be discussed with potential ICD recipients prior to implant. Further exploration of increased recognition and treatment of psychological distress in ICD recipients is warranted.
BACKGROUND: The prevalence of multi-morbidity in implantable cardioverter defibrillator (ICD) recipients is approximately 25%. Multi-morbidity is associated with poor health and psychological outcomes in this population and may affect ICD recipients' quality-of-life (QOL). The purpose of this study was to determine the prevalence of psychological distress (anxiety, depressive symptoms, and Type-D personality) in ICD recipients with varying levels of comorbidities, and to examine the association between multi-morbidity burden and QOL in this population. METHODS: All adults listed in the Swedish ICD and Pacemaker Registry in 2012 with an ICD implanted for at least one year were invited to participate in this study. Binary logistic regression was used to predict QOL using the EQ-5D mean index dichotomized based on median QOL scores. Multi-morbidity burden scores were based on quartile groupings. RESULTS: A total of 2658 ICD recipients participated in the study (with a mean age of 65, 20.6% female, mean implant duration of 4.7 years, with 35.4% implanted for primary prevention of sudden cardiac arrest). Greater multi-morbidity burden, female sex, not working outside the home, history of ICD shock, negative ICD experience, higher levels of ICD-related concerns, and the presence of anxiety, depression, or Type D personality were associated with worse QOL in ICD recipients. Predictors differed by multi-morbidity burden level. CONCLUSIONS: Multi-morbidity burden and psychological distress is an essential factor related to QOL. This issue should be discussed with potential ICD recipients prior to implant. Further exploration of increased recognition and treatment of psychological distress in ICD recipients is warranted.
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