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Quality-of-life in patients receiving implantable cardioverter defibrillators at or before age 40
A M Dubin1, W P Batsford, R J Lewis
1Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
Insights
Young patients receiving implantable cardioverter-defibrillators (ICDs) report good health and daily functioning, but experience body image and social concerns. Despite these challenges, they are active and benefit from ICDs.
Area of Science:
- Cardiology
- Electrophysiology
- Quality of Life Research
Background:
- Implantable cardioverter-defibrillators (ICDs) are increasingly used in younger populations.
- Younger patients may have unique concerns regarding ICDs compared to older demographics.
Purpose of the Study:
- To investigate the quality-of-life (QoL) issues in patients aged 40 or younger at the time of ICD implantation.
- To understand the specific concerns and benefits experienced by young ICD recipients.
Main Methods:
- A modified SF-36 health questionnaire was administered to patients followed by the Yale electrophysiology service.
- 18 patients (mean age 28) who received ICDs were included, with 16 (88%) responding.
Main Results:
- All patients reported good to excellent health, with 38% noting improvement post-ICD.
- Most patients could perform daily activities, and 68% engaged in moderate physical activity.
- Significant concerns included body image (63%), social interactions (75%), and sexual encounters (50%).
Conclusions:
- Young ICD recipients generally experience positive health outcomes and maintain active lifestyles.
- Body image and social concerns are prevalent, impacting psychosocial well-being.
- Despite challenges, young patients benefit from ICDs, remaining productive members of society.
Abstract:
As the use of ICDs increases, more young patients will be eligible to receive these devices. Such patients may have different concerns than older patients who more commonly receive ICDs. We investigated quality-of-life issues in patients followed by the Yale electrophysiology service who were < or = 40 years old (mean = 28) at the time of ICD implant. Mean time since ICD placement was 3.3 years. Each patient received a modified SF-36 health questionnaire; 16 (88%) of 18 responded. Nine were women; ten were married. The highest education level attained was high school for 6 (37%), and college or beyond for 10 (63%). Ten patients were employed; eight held the same job before and after ICD placement. Four women conceived after ICD implantation; one experienced ICD discharge during pregnancy. All delivered healthy infants. All patients felt their health was good to excellent, with 6 (38%) reporting an improvement in health since ICD placement. All felt capable of performing the activities of daily living, while 68% engaged freely in moderate physical activities. All patients felt they were average to very attractive. However, 63% worried about how their clothes fit with the ICD. Three quarters of the patients felt the ICD interfered with social interactions, while 50% were concerned about sexual encounters. Thus, even though these young patients have body image concerns and may limit their activities to some degree, they are productive, active members of society who have benefitted from ICD placement.