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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Quality of life in patients with implantable cardioverter defibrillators
Johnson Francis1, Beena Johnson, Michael Niehaus
1Medical College Calicut, Kerala, India. francisj@calicutmedicalcollege.ac.in
Insights
Implantable cardioverter defibrillators (ICDs) are life-saving devices, but shocks can negatively impact quality of life. Activating antitachycardia pacing may reduce painful shocks and improve patient well-being.
Area of Science:
- Cardiology
- Medical Devices
- Quality of Life Research
Background:
- Implantable cardioverter defibrillators (ICDs) are crucial for managing life-threatening ventricular arrhythmias.
- While cost-effective, ICD shock delivery can cause significant psychological distress and reduce perceived quality of life.
Purpose of the Study:
- To systematically analyze the impact of ICDs on patient quality of life.
- To identify factors influencing quality of life outcomes in ICD recipients.
Main Methods:
- A systematic meta-analysis of studies reporting quality of life in ICD patients was conducted.
- Searches included professional databases, related articles, and reference lists.
Main Results:
- Thirty studies involving 3412 patients were analyzed; 5 were large randomized trials.
- The Medical Outcome Study 36-item Short Form health survey was commonly used.
- Most randomized trials showed neutral or improved quality of life, except for patients receiving shocks.
Conclusions:
- ICDs generally maintain or improve quality of life for most patients.
- Patients experiencing shocks reported worsened quality of life.
- Activating antitachycardia pacing is recommended to minimize painful shocks and improve patient well-being.
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 -94 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.
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