Internal cardioverter defibrillator device discharge: experiences of patients and family members

The purpose of the study was to describe sensations, symptoms, and experiences of internal cardioverter defibrillator (ICD) activations from the perspective of patients and a member of their family.

A prospective, descriptive study with qualitative and quantitative measures was used. Patients with an ICD returned a device activation form within 24 hours after receiving a shock and both patient and family members participated in interviews at 1, 3, and 6 months after ICD implantation.

Twenty-two patients with ICD (two women, 20 men) between the ages of 24 to 72 years (mean 56.5 years) and one family member per patient participated. Family members ranged in age from 43 to 67 years (mean 52.6 years) and were primarily spouses.

The most distressing aspects of receiving a shock were lack of warning, multiple shocks, and progressively increased sensations with multiple shocks. Mean shock intensity was ranked 5.44 on visual analog scale with a range of 0 to 10. The most frequently reported symptoms and sensations were generalized nervousness and terror/fear. Dizziness, general weakness, nausea and vomiting, palpitations, and chest soreness were also noted.

Nursing interventions related to education of patients with an ICD and their families can incorporate knowledge of these experiences to facilitate anticipatory guidance and strengthen preparation of both the patient and family member for ICD device discharge. Further research as device technology evolves is warranted.