STOCKHOLM — Patients who get implanted cardioverter defibrillators may feel depressed and anxious at first, but with time usually feel better emotionally, according to results from a study of 70 patients who were followed for 4 years after implantation.
“You can tell patients that they may first feel distressed, but over time they will eventually adjust to having a device in place,” Diane L. Carroll, R.N., Ph.D., said at a poster presentation at the annual congress of the European Society of Cardiology. “This is the first study to look at patients with ICDs [implanted cardioverter defibrillators] for more than 2 years.”
Among the 70 ICD patients who were followed, 80% received the device because they had coronary artery disease and 20% because they had a genetic disease. Their average New York Heart Association class was 2.5, and their average left ventricular ejection fraction was 36%. During the 4 years of follow-up, 10 patients died, and another 19 were lost to follow-up or withdrew from the study.
During the 4 years after getting an ICD, their mean mental health composite summary scores improved significantly, even though their physical health composite summary scores continued to decline. The mental health score improvements included reductions in levels of anger, confusion, fatigue, depression, and anxiety, said Dr. Carroll, a clinical nurse-specialist in Patient Care Services at Massachusetts General Hospital in Boston. Patients also had increased vigor scores with time.
The findings highlighted the opportunity to quickly engage these patients in a cardiac rehabilitation program when they receive their ICD, Dr. Carroll said in an interview. New studies should assess the effect of strength training and activity progression on ICD patients in a supervised environment.
Although 19 of the original 70 patients were alive but declined to participate with follow-up, Dr. Carroll was doubtful that they dropped out because of psychological distress. All 19 were contacted; in general, they didn't participate in the follow-up because they felt good and didn't think that they had the time, she said.
'You can tell patients that they may first feel distressed, but over time they will eventually adjust.' DR. CARROLL