The friend within? The implantable cardioverter defibrillator between saving lives and chronically impairing them

Area of Science:

• Medical Sociology
• Cardiology
• Bioethics

Background:

• Biomedicine often overlooks patient lived experiences with chronic conditions.
• Technological advancements like implantable cardioverter defibrillators (ICDs) are framed as victories over acute disease.
• Chronic illness management requires understanding the patient's perspective beyond life expectancy.

Purpose of the Study:

• To explore how implantable cardioverter defibrillators (ICDs) shape the chronicity of cardiac disease.
• To investigate the patient experience of living with an embodied technology.
• To examine the interplay of risk, quality of life, and choice for patients with ICDs.

Main Methods:

• Participant observation in a clinical setting.
• Interviews with clinicians.
• Analysis of patient experiences with cardiac disease and ICDs.

Main Results:

• Patients face a continuous tension managing acute cardiac risk and daily life disruptions from the ICD.
• The concept of 'patient choice' and a 'technological imperative' to avoid risk limit patients' coping strategies.
• Living with an ICD involves a complex process of identifying with the disease and the implanted technology.

Conclusions:

• The focus on technological solutions and risk avoidance in cardiac care can inadvertently limit patients' ability to adapt to chronic illness.
• Rethinking patient autonomy and the 'technological imperative' is crucial for improving the quality of life for individuals with ICDs.
• Embodied technology significantly influences the experience and management of chronic cardiac conditions.