Effects of ICD Shock and Anti-Tachycardia Pacing on Anxiety and Quality of Life

MedicalResearch.com Interview with:
Alessandro Paoletti Perini, MD, PhD and

Valentina Kutyifa MD, PhD
University of Rochester Medical Center
Heart Research Follow-Up Program
Rochester, New York, 14642

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The present study is a pre-specified sub-study of the Multicenter Automatic Defibrillator Implantation Trial – Reduce Inappropriate Therapy (MADIT-RIT), which was published on the New England Journal of Medicine in 2012. The main trial showed that innovative ICD programming was associated with reduction in inappropriate ICD therapy and mortality.

In the present investigation we focused on the detrimental effects that ICD firings, either appropriate or inappropriate, may have on patients’ psychological well-being.

We observed that multiple appropriate and inappropriate shocks are associated with increased levels of ICD-related anxiety, a specific kind of psychological disorder which affects patients implanted with an ICD. Multiple appropriate ATP were also proved associated with higher anxiety, although not as much as shocks. On the other hand, we did not find a significant association with anxiety for multiple inappropriate ATP.

MedicalResearch.com: What should readers take away from your report?

Response: ICD-related anxiety represents a relevant clinical issue, affecting patients with implanted ICDs that might be associated with impaired quality of life.

This is particularly important in females and in young patients, who are more prone to being affected by ICD-related distress.

Our data show that this aspect must be carefully investigated with dedicated instruments, such as the Florida Shock Anxiety Scale that we used in our study. In fact, clinical questionnaires exploring a more general spectrum of physical and psychological well-being might be inadequate to unmask this specific psychological discomfort, so that clinicians may be unaware of the suffering of their patients.

Moreover, the results of this sub-study strengthen the clinical implications of the MADIT-RIT study, that innovative ICD programming is preferred to reduce inappropriate interventions from the device, and, through the latter, to improve the psychological well-being of our patients.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We are hopeful that in the next years researchers will focus more and more on the psychological impact of medical practice. We believe that our results may encourage such studies.

MedicalResearch.com: Is there anything else you would like to add?

Response: The MADIT-RIT study was supported by an unrestricted grant by Boston Scientific to the University of Rochester Medical Center, Rochester, NY. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper and its final contents.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Effects of Implantable Cardioverter Defibrillator Shock and Anti-Tachycardia Pacing on Anxiety and Quality of Life: A MADIT-RIT Sub-study

Perini, Alessandro Paoletti et al.

American Heart Journal , Volume 0 , Issue 0 ,

DOI: http://dx.doi.org/10.1016/j.ahj.2017.03.009

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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