The Psychological Impact of Implantable Cardioverter Defibrillators: A Narrative Review

Implantable cardioverter defibrillators (ICDs) are critical to the prevention of sudden cardiac death caused by life-threatening arrhythmias such as ventricular tachycardia and fibrillation. While their clinical value is well-established, the psychological impact of living with an ICD remains underrecognized. Patients often experience anticipatory anxiety, depression, Post-Traumatic Stress Disorder (PTSD), and reduced quality of life. These challenges can begin before implantation, persist after both appropriate and inappropriate shocks, and be worsened by fears of device malfunction, recalls, or cybersecurity risks. Many patients alter postimplantation behaviors, avoiding physical activity and reporting diminished trust in medical technology. The burden is especially significant in children, alongside those who experience multiple or unnecessary shocks. Despite increased awareness, mental health care remains poorly integrated into cardiology. Cognitive Behavioural Therapy (CBT), structured patient education, and transparent communication around device updates and recalls have shown effectiveness. In conclusion, addressing this gap is essential to improving outcomes and quality of life.