Quality of Life in Patients with Implantable Cardioverter Defibrillators

Francis, Johnson and Johnson, Beena and Niehaus, Michael (2006) Quality of Life in Patients with Implantable Cardioverter Defibrillators. [Journal (Paginated)]

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Background: The implantable cardioverter defibrillator (ICD) is a life saving device for individuals with life threatening ventricular arrhythmias. There is no doubt that it is a cost effective therapy in various congenital and acquired arrhythmogenic disorders. Nevertheless, shock delivery may be painful and frightening which causes psychological distress and deterioration of perceived quality of life. Methods: A systematic meta-analysis on studies reporting quality of life in patients implanted with ICDs was done using professional databases. Related articles and references of the relevant articles were also searched for suitable studies. Results: Thirty studies with a total of 3412 patients on implantable defibrillators were identified. Five of them were large randomised studies with a total of 1680 patients, while 25 were non-randomised studies. Medical Outcome Study 36-item Short Form health survey (SF - 36) was the most common instrument used for assessment of quality of life. Only one of the 5 major randomised trial reported worsening of quality of life after implantation of a defibrillator. In the subgroup of patients receiving shocks, three out of the five trials reported worsening of quality of life. Summary: Most of the randomised studies showed either neutral or better quality of life in patients on implantable defibrillators. In the subset of patients receiving shocks, worsening of quality of life was found in most randomised studies. Therefore, activation of antitachycardia pacing should be performed in every ICD-patient in order to miminze painful shocks and consequent deterioration of quality of life.

Item Type:Journal (Paginated)
Keywords:Implantable defibrillator; meta analysis; quality of life
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:5237
Deposited By:Indian Pacing and Electrophysiology, Journal
Deposited On:28 Oct 2006
Last Modified:11 Mar 2011 08:56

References in Article

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1. Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators: A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 1997; 337: 1576–1583.

2. Moss AJ, Hall WJ, Cannom DS, et al. Improved survival with an implantable defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial (MADIT) Investigators. N Engl J Med 1996; 335: 1933–1940.

3. Heidenreich PA, Keeffe B, McDonald KM, Hlatky MA. Overview of randomized trials of antiarrhythmic drugs and devices for the prevention of sudden cardiac death. Am Heart J. 2002;144:422-30.

4. Luderitz B, Jung W, Deister A, Marneros A, Manz M. Patient acceptance of the implantable cardioverter defibrillator in ventricular tachyarrhythmias. Pacing Clin Electrophysiol. 1993;16:1815-21.

5. Dougherty CM. Longitudinal recovery following sudden cardiac arrest and internal cardioverter defibrillator implantation: survivors and their families. Am J Crit Care. 1994;3:145-54.

6. Arteaga WJ, Windle JR. The quality of life of patients with life-threatening arrhythmias. Arch Intern Med. 1995;155:2086-91.

7. Bainger EM, Fernsler JI. Perceived quality of life before and after implantation of an internal cardioverter defibrillator. Am J Crit Care. 1995;4:36-43.

8. May CD, Smith PR, Murdock CJ, Davis MJ. The impact of the implantable cardioverter defibrillator on quality-of-life. Pacing Clin Electrophysiol. 1995;18:1411-8.

9. Vitale MB, Funk M. Quality of life in younger persons with an implantable cardioverter defibrillator. Dimens Crit Care Nurs. 1995;14:100-11.

10. Chevalier P, Verrier P, Kirkorian G, Touboul P, Cottraux J. Improved appraisal of the quality of life in patients with automatic implantable cardioverter defibrillator: a psychometric study. Psychother Psychosom. 1996;65:49-56.

11. Dubin AM, Batsford WP, Lewis RJ, Rosenfeld LE. Quality-of-life in patients receiving implantable cardioverter defibrillators at or before age 40. Pacing Clin Electrophysiol. 1996;19:1555-9.

12. Craney JM, Mandle CL, Munro BH, Rankin S. Implantable cardioverter defibrillators: physical and psychosocial outcomes. Am J Crit Care. 1997;6:445-51.

13. Herrmann C, von zur Muhen F, Schaumann A, Buss U, Kemper S, Wantzen C, Gonska BD. Standardized assessment of psychological well-being and quality-of-life in patients with implanted defibrillators. Pacing Clin Electrophysiol. 1997;20:95-103.

14. Jessurun ER, Hutten BA, van Hemel NM, Kelder JC, Defauw JJ, Bakema H. Good experiences with an implantable automatic defibrillator with transvenous electrodes for patients with life-threatening arrhythmias. Ned Tijdschr Geneeskd. 1997;141:1475-80.

15. Stankoweit B, Muthny FA, Block M, Breithardt G. Quality of life after implantation of a cardioverter-defibrillator (ICD) - results of an empirical study of 132 ICD patients. Z Kardiol. 1997;86:460-8.

16. Herbst JH, Goodman M, Feldstein S, Reilly JM. Health-related quality-of-life assessment of patients with life-threatening ventricular arrhythmias. Pacing Clin Electrophysiol. 1999;22:915-26.

17. Namerow PB, Firth BR, Heywood GM, Windle JR, Parides MK. Quality-of-life six months after CABG surgery in patients randomized to ICD versus no ICD therapy: findings from the CABG Patch Trial. Pacing Clin Electrophysiol. 1999;22:1305-13.

18. Carroll DL, Hamilton GA, Kenney BJ. Changes in health status, psychological distress, and quality of life in implantable cardioverter defibrillator recipients between 6 months and 1 year after implantation. Eur J Cardiovasc Nurs. 2002;1:213-9.

19. Duru F, Buchi S, Klaghofer R, Mattmann H, Sensky T, Buddeberg C, Candinas R. How different from pacemaker patients are recipients of implantable cardioverter-defibrillators with respect to psychosocial adaptation, affective disorders, and quality of life? Int J Nurs Pract. 2002;8:68-74.

20. Hsu J, Uratsu C, Truman A, Quesenberry C, McDonald KM, Hlatky MA, Selby J. Life after a ventricular arrhythmia. Am Heart J. 2002;144:404-12.

21. Irvine J, Dorian P, Baker B, O'Brien BJ, Roberts R, Gent M, Newman D, Connolly SJ. Quality of life in the Canadian Implantable Defibrillator Study (CIDS). Am Heart J. 2002;144:282-9.

22. Kamphuis HC, De Leeuw JR, Derksen R, Hauer R, Winnubst JA. A 12-month quality of life assessment of cardiac arrest survivors treated with or without an implantable cardioverter defibrillator. Europace. 2002;4:417-25.

23. Schron EB, Exner DV, Yao Q, Jenkins LS, Steinberg JS, Cook JR, Kutalek SP, Friedman PL, Bubien RS, Page RL, Powell J. Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation. 2002;105:589-94.

24. Wallace RL, Sears SF Jr, Lewis TS, Griffis JT, Curtis A, Conti JB. Predictors of quality of life in long-term recipients of implantable cardioverter defibrillators. J Cardiopulm Rehabil. 2002;22:278-81.

25. Newman DM, Dorian P, Paquette M, Sulke N, Gold MR, Schwartzman DS, Schaaf K, Wood K, Johnson L; Worldwide Jewel AF AF-Only Investigators. Effect of an implantable cardioverter defibrillator with atrial detection and shock therapies on patient-perceived, health-related quality of life. Am Heart J. 2003;145:841-6.

26. Spurrell P, Mitchell A, Kamalvand K, Sulke N. Quality of life after use of the patient activated atrial defibrillator. Int J Clin Pract. 2003;57:30-4.

27. Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL, Bitar C, Morady F; AMIOVIRT Investigators. Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia - AMIOVIRT. J Am Coll Cardiol. 2003;41:1707-12.

28. van Ittersum M, de Greef M, van Gelder I, Coster J, Brugemann J, van der Schans C. Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator. Int J Rehabil Res. 2003;26:117-22.

29. Godemann F, Butter C, Lampe F, Linden M, Werner S, Behrens S. Determinants of the quality of life (QoL) in patients with an implantable cardioverter/defibrillator (ICD). Qual Life Res. 2004;13:411-6.

30. Hamilton GA, Carroll DL. The effects of age on quality of life in implantable cardioverter defibrillator recipients. J Clin Nurs. 2004;13:194-200.

31. Ricci R, Quesada A, Pignalberi C, Roda J, Disertori M, Capucci A, Raviele A, Santini M. Dual defibrillator improves quality of life and decreases hospitalizations in patients with drug refractory atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15:286-91.

32. Sears SF, Serber ER, Lewis TS, Walker RL, Conners N, Lee JT, Curtis AB, Conti JB. Do positive health expectations and optimism relate to quality-of-life outcomes for the patient with an implantable cardioverter defibrillator? J Cardiopulm Rehabil. 2004;24:324-31.

33. Wathen MS, DeGroot PJ, Sweeney MO, Stark AJ, Otterness MF, Adkisson WO, Canby RC, Khalighi K, Machado C, Rubenstein DS, Volosin KJ; PainFREE Rx II Investigators. Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: Pacing Fast Ventricular Tachycardia Reduces Shock Therapies (PainFREE Rx II) trial results. Circulation. 2004;110:2591-6.

34. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473-83.


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