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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
Preventing Posttraumatic Stress Disorder After an Implantable Cardioverter Defibrillator Shock With a Heart Rate
Cynthia M Dougherty1, Elizabeth Frazier2, Wei-Lun Chang3
1Cynthia M. Dougherty, PhD, ARNP, FAAN, FAHA, Charles and Gerda Endowed Professor in Nursing, University of Washington School of Nursing, and Adjunct Professor, Biobehavioral Nursing and Health Informatics, University of Washington School of Medicine, Seattle.
Background:
Implantable cardioverter defibrillator (ICD) shocks are unexpected, painful, traumatic, and can lead to posttraumatic stress disorder (PTSD).
Objective:
To describe the feasibility and efficacy of the Heart Rate Self-Monitoring (HRSM) intervention to reduce PTSD symptoms post-ICD shock.
Methods:
A single-group, prepost design was used to assess study outcomes. In the HRSM intervention we used Polar HR monitoring and 4-weekly, nurse-led coaching sessions to review responses to tailored walking and deep breathing exercises. Outcomes included ICD shock anxiety, PTSD symptoms, depression, steps/day, self-efficacy, and salivary cortisol.
Results:
Ten participants (100% male, 89% Caucasian, 58 years, and 55% prior ICD shock) completed the study. Intervention feasibility was established. Postintervention, ICD shock anxiety ( P = .03), PTSD symptoms ( P = .06), self-monitoring behaviors ( P = .02), and salivary cortisol ( P = .10) decreased. Steps/day and depression remained stable.
Conclusion:
After ICD shock, participation in HRSM was associated with decreased anxiety, PTSD symptoms, and salivary cortisol.
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