© 2002 by European Society of Cardiology
A 12-month quality of life assessment of cardiac arrest survivors treated with or without an implantable cardioverter defibrillator
1Workgroup on Psychology of Health and Illness, University Medical Centre Utrecht The Netherlands; 2Department of Cardiology, Heart Lung Centre Utrecht The Netherlands
BACKGROUND: Previous studies indicate that the implantable cardioverter defibrillator (ICD) has a large impact on the quality of life of patients. The effects of having an ICD over longer periods of times has been less studied.
OBJECTIVE: To assess the quality of life and well-being of cardiac arrest survivors who have received an implantable cardioverter defibrillator (ICD) or other treatment.
METHODS: 168 patients were monitored for 1 year and completed four questionnaires.
RESULTS: No differences were found between the two treatments regarding quality of life (except for pain, ICD patients perceived less pain) and well-being. A significant improvement in physical and social function, and in mental health was found in the first 6 months. Older patients (60 years or older) perceived less improvement in their health than younger patients. Women reported having poorer social function. The prevalence of anxiety and probable depression was high irrespective of the treatment received: anxiety and depressive symptoms did not change significantly between 1 and 12 months after discharge. Patients with higher anxiety scores experienced less improvement in health and patients with more depressive symptoms experienced poorer social function.
CONCLUSIONS: The prevalence of anxiety and probable depression was high in cardiac arrest survivors. Probable depression affected social function. Those patients who felt anxious experienced less health improvement. Quality of life and well-being were not affected by the type of treatment. We conclude that surviving an out-of-hospital cardiac arrest has a greater impact on patients than the treatment received.
Key Words: out-of-hospital cardiac arrest, arrhythmia, implantable cardioverter defibrillator, quality of life, well-being, anxiety, depression
Correspondence: H. C. M. Kamphuis, Workshop Psychology of Health and Illness, Stratenum 3.130, University Medical Centre Utrecht, Box 85500, 3508 GA Utrecht, The Netherlands. E-mail: h.c.m.kamphuis{at}med.uu.nl
[1] Konings-Dalstra JAA and Reitsma JB. Hart en vaatziekten in nederland 1999 1999; Den Haag Nederlandse Harstichting.
[2] Mason P and McPherson C. Implantable cardioverter defibrillator: a review. Heart and Lung: Journal of Critical Care (Heart Lung) 1992; 21: 141147.
[3] Wever EF. Therapeutic Strategies for Sudden Cardiac Arrest caused by Ventricular Tachyarrhythmia University Utrecht 9-6-1995.
[4] Freericks MP, Hauer RNW, Penn OCKM, Hitchcock JF, Meursing BTJ, Robles de Medina EO. Eerste Nederlandse ervaring met de implanteerbare cardioverter/defibrillator. (The first experience of implanting an implantable cardioverter defibrillator in the Netherlands). Nederlandse Tijdschrift voor Geneeskunde 1987; 131: 951954.
[5] Wiklund I, Gorkin L, Pawitan Y, Schron E, Schoenberger J, Jared LL, Shumaker S. Methods for assessing quality of life in the cardiac arrhythmia suppression trail (CAST). Quality of Life Research 1992; 1: 187201.
[6] Zee van der KI and Sanderman R. Het meten van de algemene gezondheidstoestand met de Rand-36. Een handleiding 1990; Groningen Noordelijk Centrum voor Gezondheidsvraagstukken. Rijksuniversiteit Groningen.
[7] Ware JE and Scherbourne CD. The RAND-36 short-form health states survey: I. Concept framework and item selection. Medical Care 1992; 30: 473481.[Web of Science][Medline]
[8] Erdman RAM. Welbevinden hartpatienten 1981; Rotterdam .
[9] Ploeg van der HM, Defares PB, Spielberger CD. Handleiding bij de Zelf-Beoordelings Vragenlijst. Een nederlandstalige bewerking van de Spielberger State-Trait Anxiety Inventory 1992; Lisse Swets & Zeitlinger BV.
[10] Hegel MT, Griegel LE, Black C, Goulden L, Ozahowski T. Anxiety and depression in patients receiving implanted cardioverter-defibrillators: a longitudinal investigation. Int J Psychiatry Med 1997; 27: 5769.[Web of Science][Medline]
[11] Elliot D. Comparison of three instruments for measuring patient anxiety in a coronary care unit. Intensive and Critical Care Nursing 1993; 9: 195200.[Medline]
[12] Bouma J, Ranchor AV, Sanderman R, Sonderen van E. Het meten van symptomen van depressie met de CES-D. Een handleiding 1995; Groningen Noordelijk Centrum voor Gezondheidsvraagstukken Rijksuniversiteit Groningen.
[13] Orme JG and Herz EJ. Factorial and discriminant validity of the center for epidemiologic studies depression (CES-D) scale. J Clin Psychol 1986; 42: 2833.[Web of Science][Medline]
[14] Williams JR Jr, Mulrow CD, Kroenke K, Dhanda R, Badgett RG, Omori D, Lee S. Case-finding for depression in primary care: a randomized trial. Am J Medicine 1999; 106: 3643.[CrossRef][Web of Science][Medline]
[15] SPSS 10.0 for Windows and Smart Viewer 2000; Austria Sony DADC.
[16] Hair JF, Anderson RE, Tatham RL, Black WC. Mutivariate Data Analysis 1998; 5th Edn Upper Saddle River Prentice-Hall International Inc.
[17] Stevens J. Applied Multivariate Statistics for the Social Sciences 2001; 3rd Edn Mahwah Lawrence Erlbauw Associates, Publishers.
[18] Dougherty CM. Longitudinal recovery following sudden cardiac arrest and internal cardioverter defibrillator implantation: survivors and their families. Am J Crit Care 1994; 3: 145154.[Abstract]
[19] Lüderitz B, Jung W, Deister A, Manz M. Patient acceptance of implantable cardioverter defibrillator devices: changing attitudes. Am Heart J 1994; 127: 11791184.[CrossRef][Web of Science][Medline]
[20] Cooper DK, Luceri RM, Thurer RL, Myerburg RJ. The impact of the automatic implantable cardioverter defibrillator on quality of life. Clin Progress Electrophysiol Pacing 1986; 4: 306309.
[21] Dubin AM, Batsford WP, Lewis RJ, Rosenfeld LE. Quality-of-life in patients receiving implantable cardioverter defibrillators at or before age 40. Pacing Clin Electrophysiol 1996; 19: 15551559.[CrossRef][Medline]
[22] Carroll DL, Hamilton GA, McGovern BA. Changes in health status and quality of life and the impact of uncertainty in patients who survive life-threatening arrhythmias. Heart Lung 1999; 28: 251260.[CrossRef][Web of Science][Medline]
[23] May CD, Smith PR, Murdock CJ, Davis MJ. The impact of the implantable cardioverter defibrillator on quality-of-life. Pacing Clin Electrophysiol 1995; 18: 14111418.[CrossRef][Medline]
[24] Herbst JH, Goodman M, Feldstein S, Reilly JM. Health-related quality-of-life assessment of patients with life-threatening ventricular arrhythmias. Pacing Clin Electrophysiol 1999; 22: 915926.[CrossRef][Medline]
[25] Pycha C and Calabrese JR. Good Psychosocial Adaptation to Implantable Cardioverter Defibrillators. 1990; .
[26] Dougherty CM. Psychological reactions and family adjustment in shock versus no shock groups after implantation of internal cardioverter defibrillator. Heart Lung 1995; 24: 281291.[CrossRef][Web of Science][Medline]
[27] Kolar JA and Dracup K. Psychosocial adjustment of patients with ventricular dysrhythmias. J Cardiovasc Nurs 1990; 4: 4455.[Medline]
[28] Sullivan MD, LaCroix A, Baum A, Grothaus LC, Katon WJ. Functional status in coronary artery disease: a one-year prospective study of the role of anxiety and depression. Am J Medicine 1997; 103: 348356.[CrossRef][Web of Science][Medline]
[29] Herrmann C, von-zur Muhen F, Schaumann A, Buss U, Kemper S, Wantzen C, Gonska BD. Standardized assessment of psychological well-being and quality-of-life in patients with implanted defibrillators. Pacing Clin Electrophysiol 1997; 20: 95103.[CrossRef][Medline]
[30] Lüderitz B, Jung W, Deister A, Marneros A, Manz M. Patient acceptance of the implantable cardioverter defibrillator in ventricular tachyarrhythmias. Pacing Clin Electrophysiol 1993; 16: 18151821.[CrossRef][Medline]
[31] Vitale MB and Funk M. Quality of life in younger persons with an implantable cardioverter defibrillator. Dimens Crit Care Nurs 1995; 14: 100111.[CrossRef][Medline]
[32] Jessurun ER, Hutten BA, van Hemel NM, Kelder JC, Defauw JJ, Bakema H. [Good experiences with an implantable automatic defibrillator with transvenous electrodes for patients with life-threatening arrhythmias] Goede ervaringen met een implanteerbare automatische defibrillator met transveneuze elektroden voor patienten met levensbedreigende hartritmestoornissen. Ned Tijdschr Geneeskd 1997; 141: 14751480.[Medline]
[33] Craney JM, Mandle CL, Munro BH, Rankin S. Implantable cardioverter defibrillators: physical and psychosocial outcomes. Am J Crit Care 1997; 6: 445451.[Abstract]
[34] Bainger EM and Fernsler JI. Perceived quality of life before and after implementation of an internal cardioverter defibrillator. Am J Crit Care 1995; 4: 3643.[Abstract]
[35] Chevalier P, Verrier P, Kirkorian G, Touboul P, Cottraux J. Improved appraisal of the quality of life in patients with automatic implantable cardioverter defibrillator: a psychometric study. Psychother Psychosom 1996; 65: 4956.[CrossRef][Web of Science][Medline]
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