Implantable Cardioverter Defibrillator (ICD) surgery: highlighting the psychological consequences

ICD snip

Adapted from the article of the same name, which was published in October 2017 in the British Journal for Cardiac Nursing.

Abstract

An implantable cardioverter defibrillator (ICD) can terminate episodes of ventricular tachycardia or fibrillation, thereby reducing the risk of sudden death in patients with a range of cardiac diseases. It is recommended as both a primary and secondary prevention measure. The survival benefit of ICD surgery is well documented, and it is a cost-effective alternative to optimal pharmacological therapy to prevent sudden cardiac death. Many patients who have had an ICD fitted, however, experience compromised quality of life as well as depression and anxiety after implantation. ICD shocks, whether appropriate or inappropriate, play an important role in the post-surgery experience of ICD recipients, as does personality and social support. Psychological screening of patients who have an ICD fitted is recommended as part of cardiac rehabilitation.

Key Points

  • Although implantable cardioverter defibrillators improve survival, many patients experience a lower quality of life and psychological problems after surgery
  • Shocks, whether appropriate or inappropriate, are associated with an increased risk of anxiety and depression
  • Female ICD recipients have been shown to receive more ICD shocks and to experience higher shock-anxiety than their male counterparts
  • Anxiety has also been shown to be high in spouses and partners of ICD patients, and in some cases higher than that of patients themselves
  • It is recommended that all ICD patients be assessed up to 12 months post-surgery for depression, anxiety, social support, Type D personality, acceptance of the ICD, and shock anxiety

Full article reference:

Alun C. Jackson & Barbara Murphy, “ICD surgery: highlighting the psychological consequences”. British Journal of Cardiac Nursing, Vol. 12 No. 10, published October 2017.

 

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