The impact of the implantable cardioverter defibrillator on quality-of-life

Area of Science:

• Cardiology
• Medical Devices
• Quality of Life Research

Background:

• The implantable cardioverter defibrillator (ICD) is a critical intervention for managing life-threatening ventricular arrhythmias.
• While ICDs effectively reduce mortality, their impact on patient quality-of-life (QoL) remains less understood.
• Assessing QoL changes is crucial for comprehensive patient care following ICD implantation.

Purpose of the Study:

• To prospectively evaluate the impact of ICD implantation on patient quality-of-life.
• To examine changes in functional capacity, employment status, and rehospitalization rates post-ICD.
• To identify specific QoL domains affected by ICD therapy.

Main Methods:

• Prospective study involving 21 patients undergoing ICD implantation.
• Quality-of-life assessed using the Sickness Impact Profile (SIP) questionnaire pre-implantation and at 6 and 12 months post-implantation.
• Employment status and rehospitalization rates were also monitored.

Main Results:

• Overall SIP scores significantly worsened at 6 months post-implantation but returned to baseline by 12 months.
• The psychosocial dimension of QoL showed a transient decline at 6 months, particularly in emotional behavior, alertness, and social interaction.
• Functional capacity remained largely unchanged, with one patient improving from NYHA Class III to II; early retirement and rehospitalizations were noted.

Conclusions:

• Quality-of-life following ICD implantation experiences a transient, predominantly psychosocial decline.
• QoL scores typically recover to pre-implantation levels within 12 months.
• Healthcare providers should anticipate and manage temporary QoL fluctuations and address factors like early retirement and rehospitalizations.