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Changes in psychosocial distress in outpatients with heart failure with implantable cardioverter defibrillators

Sue A Thomas1, Erika Friedmann, Stephen S Gottlieb

  • 1University of Maryland, School of Nursing, Baltimore, Maryland 21201-1579, USA.

Heart & Lung : the Journal of Critical Care
|March 4, 2009
PubMed

Insights

Implantable cardioverter defibrillators (ICDs) for heart failure patients can cause distress. While some psychosocial issues improve, many patients still experience depression, anxiety, or reduced social support long-term.

Area of Science:

  • Cardiology
  • Psychology
  • Medical Devices

Background:

  • Implantable cardioverter defibrillators (ICDs) are used for sudden cardiac arrest (SCA) prevention.
  • Psychosocial distress is known in patients receiving ICDs after arrhythmic events.
  • The psychosocial impact of ICDs for primary prevention in heart failure patients is not well understood.

Purpose of the Study:

  • To examine changes in psychosocial status among heart failure patients receiving ICDs for primary prevention.
  • To assess the long-term psychological effects of ICD implantation in this population.

Main Methods:

  • Prospective study involving 57 heart failure patients implanted with ICDs.
  • Psychosocial status assessed using depression, anxiety, and social support inventories every 6 months for up to 2 years.
  • Linear mixed models used to analyze changes in psychosocial variables over time.

Main Results:

  • Initially, 35% of patients were depressed and 45% were anxious.
  • Overall depression decreased, but increased following ICD shocks.
  • Anxiety decreased in NYHA class III patients but not class II.
  • Younger patients experienced greater decreases in social support.

Conclusions:

  • A significant proportion of heart failure patients with ICDs experience persistent psychosocial challenges, including depression, anxiety, and diminished social support, even after two years.
  • These findings highlight the need for interventions to mitigate the psychosocial burden associated with ICDs in primary prevention.
  • Further research into supportive strategies for ICD recipients is warranted.

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