Evaluation of patients' quality of life aspects after cardiac pacemaker implantation

Barros, Rubens Tofano de; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes; Borges, Juliana Bassalobre Carvalho

doi:10.5935/1678-9741.20140009

Cited by 30 publications

(55 citation statements)

References 23 publications

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“…12 Additionally, research suggests that there may be differences between the sexes at pacemaker implantation, with less favourable outcomes for women in terms of complications. 13 Patients with SSS are at risk of developing a complete AV block, with considerable variation in the estimates of risk of AV block (from < 1% up to 4.5% per year).…”

Section: Description Of Health Problemmentioning

confidence: 99%

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

Edwards¹,

Karner²,

Trevor³

et al. 2015

Health Technol Assess

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BackgroundBradycardia [resting heart rate below 60 beats per minute (b.p.m.)] can be caused by conditions affecting the natural pacemakers of the heart, such as sick sinus syndrome (SSS) and atrioventricular (AV) blocks. People suffering from bradycardia may present with palpitations, exercise intolerance and fainting. The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker.ObjectiveTo appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block.Data sourcesAll databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment database, NHS Economic Evaluations Database) were searched from inception to June 2014.MethodsA systematic review of the clinical and economic literature was carried out in accordance with the general principles published by the Centre for Reviews and Dissemination. Randomised controlled trials (RCTs) evaluating dual-chamber and single-chamber atrial pacemakers and economic evaluations were included. Pairwise meta-analysis was carried out. A de novo economic model was developed.ResultsOf 493 references, six RCTs were included in the review. The results were predominantly influenced by the largest trial DANPACE. Dual-chamber pacing was associated with a statistically significant reduction in reoperation [odds ratio (OR) 0.48, 95% confidence interval (CI) 0.36 to 0.63] compared with single-chamber atrial pacing. The difference is primarily because of the development of AV block requiring upgrade to a dual-chamber device. The risk of paroxysmal atrial fibrillation was also reduced with dual-chamber pacing compared with single-chamber atrial pacing (OR 0.75, 95% CI 0.59 to 0.96). No statistically significant difference was found between the pacing modes for mortality, heart failure, stroke, chronic atrial fibrillation or quality of life. However, the risk of developing heart failure may vary with age and device. The de novo economic model shows that dual-chamber pacemakers are more expensive and more effective than single-chamber atrial devices, resulting in a base-case incremental cost-effectiveness ratio (ICER) of £6506. The ICER remains below £20,000 in probabilistic sensitivity analysis, structural sensitivity analysis and most scenario analyses and one-way sensitivity analyses. The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers. Results from an analysis based on age (> 75 years or ≤ 75 years) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers (i.e. are less expensive and more effective) in older patients, whereas dual-chamber pacemakers are dominated by (i.e. more expensive and less effective) single-chamber atrial pacemakers in younger patients. However, these results are based on a subgroup analysis and should be treated with caution.ConclusionsIn patients with SSS without evidence of impaired AV conduction, dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers. The risk of developing a complete AV block and the lack of tools to identify patients at high risk of developing the condition argue for the implantation of a dual-chamber pacemaker programmed to minimise unnecessary ventricular pacing. However, considerations have to be made around the risk of developing heart failure, which may depend on age and device.Study registrationThis study is registered as PROSPERO CRD42013006708.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Description Of Health Problemmentioning

confidence: 99%

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

Edwards¹,

Karner²,

Trevor³

et al. 2015

Health Technol Assess

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“…Daugiacentriniai tyrimai įrodė, kad ligonių, sergančių kardiovaskulinėmis ligomis (KVL) ir širdies nepakankamumu, gyvenimo kokybė susijusi su ligos sunkumo laipsniu (funkcine klase), amžiumi, lytimi, socialine parama, psichologiniais veiksniais bei asmenybės ypatumais [3,4]. Daugelis tyrimų su pacientais, kuriems implantuotas EKS, parodė, kad jų gyvenimo kokybei poveikį turi panašūs veiksniai [5,6]. Lietuvoje 2012 m. atlikto tyrimo rezultatai rodo, kad gyvenimo kokybė priklauso nuo širdies ritmo sutrikimo trukmės iki EKS implantacijos.…”

Section: įVadasunclassified

D Tipo Asmenybių Su Implantuotu Elektrokardiostimuliatoriumi Gyvenimo Kokybės Aspektai

Ožeraitienė

Čepaitė

Gaigalaitė

2017

Medicinos Teorija Ir Praktika

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Reikšminiai žodžiai: asmenybės D tipas, depresiškumo lygmuo, elektrokardiostimuliatorius, gyvenimo kokybė, Aquarel skalė. Darbo tikslas. Išsiaiškinti, ar D tipo asmenybės bruožai bei depresiškumo lygmuo susiję su gyvenimo kokybe pacientų, kuriems implantuotas elektrokardiostimuliatorius (EKS). Tyrimo medžiaga ir metodai. Tirti 100 asmenų, kurie sirgo kardiovaskuline liga, iš jų 50 – su implantuotu EKS (amžiaus vidurkis 67,26 ± 9,73 metų), 50 – kontrolinė grupė be EKS (amžiaus vidurkis 68,08 ± 9,69). Tyrime naudotas specifinis Aquarel klausimynas gyvenimo kokybei ir susijusiems kardiologiniams simptomams įvertinti (M. A. Stofmeel ir kt., 2001), D tipo asmenybės skalė 14 (Type D scale 14, DS14, Denollet, 2005), Beko depresijos skalė (BDI-II, 1961). Rezultatai. Iš visų tiriamųjų D tipo asmenybių su neigiamo emocingumo ir socialinio uždarumo bruožais buvo 41 proc. Grupėje su implantuotu EKS tokio tipo asmenybių buvo reikšmingai daugiau (54 proc.). Depresiškumo lygmuo abiejose grupėse buvo panašus ir reikšmingai nesiskyrė. Gyvenimo kokybės balai buvo reikšmingai mažesni pacientams su implantuotu EKS (64,33 ± 16,95), palyginti su tiriamaisiais be EKS (83,45 ± 14,95), ir dar mažesni D tipo asmenybėms su EKS (58,8 ± 17,93), palyginti su ne D tipo asmenybėmis (70,82 ± 13,38) be EKS. Koreliacinė analizė parodė reikšmingas sąsajas tarp visų tiriamųjų gyvenimo kokybės ir D tipo asmenybės bruožų, amžiaus, depresiškumo lygmens. Gyvenimo kokybė buvo reikšmingai susijusi su neigiamu emocingumu (r = -0,592) ir depresiškumo lygmeniu (r = -0,615) D tipo asmenybėms, o ne D tipo asmenybių gyvenimo kokybė koreliavosi tik su depresiškumo lygmeniu (r = -0,5). Prognostinis tiesinės regresijos modelis parodė, kad reikšmingiausią ir stipriausią poveikį D tipo asmenybių gyvenimo kokybei turėjo depresiškumo lygmuo (β = -0,552). Išvados. Tirtų asmenų depresiškumo lygmuo nesusijęs su elektrokardiostimuliatoriaus implantacija. D tipo asmenybės bruožai – neigiamas emocingumas ir socialinis uždarumas reikšmingai dažnesni pacientams su elektrokardiostimuliatoriumi ir reikšmingai atvirkščiai susiję su jų gyvenimo kokybe. Pacientų su elektrokardiostimuliatoriumi depresiškumo lygmuo ir gyvenimo kokybė tarpusavyje stipriai susiję nepriklausomai nuo asmenybės tipo, o neigiamas emocingumas su gyvenimo kokybe stipriai susiję tik D tipo asmenybėms. Depresiškumo lygmuo ir D tipo asmenybės neigiamas emocingumas yra stipriausi prognostiniai veiksniai, kurie lemia blogesnę gyvenimo kokybę.

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“…One study showed that patients <50 years with pacemaker implantation had difficulty finding a life companion of similar age and experience, which, coupled with concerns about their image, family life, and job, tends to produce negative emotions, such as anxiety and depression (Sears, Burns, Handberg, Sotile, & Conti, ). In their study, Barros and Silva () showed that social inadaptation is more likely than physical discomfort to lower patients' quality of life. At the same time, the lack of knowledge about pacemakers leads to uncertainty about their bodies and lives.…”

Section: Introductionmentioning

confidence: 99%

“…In the process of peer support, patients can build friendships, exchange information, learn to accept their own disease status, learn self‐care, and understand their situation better through comparisons with others. Patients undergoing pacemaker implantation experience changes in physical, psychological, social and other aspects of their lives (Barros & Silva, ; Ghojazadeh et al, ; Lopez‐Villegas, Catalan‐Matamoros, Robles‐Musso, & Peiro, ; Tagney, ). For pacemaker patients, peer support might help them get through this difficult process.…”

Section: Introductionmentioning

confidence: 99%

Effect of peer support on health outcomes in patients with cardiac pacemaker implantation: A randomized, controlled trial

Shen

Zheng

Zhong

et al. 2019

Nursing & Health Sciences

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The aim of this study was to examine the effect of a nurse‐led telephone‐based peer support program on health outcomes in patients after cardiac pacemaker implantation. Seventy six patients who received cardiac pacemaker implantation were recruited as participants and randomly assigned to either the peer support group or the usual care group. The usual care group received routine care and health education measures provided by nurses; the peer support group received telephone‐based peer support. Health‐related quality of life, self‐care knowledge–attitudes–practice, postoperative anxiety and depression, compliance with attending scheduled follow‐up visits, and the incidence of postoperative complications were evaluated at baseline and 6 months’ postintervention for the two groups. The result showed that the interventions had a better effect on self‐care knowledge–attitudes–practice, postoperative anxiety and depression, and compliance with attending scheduled follow‐up visits in the peer support group than in the usual care group. This study confirms that telephone‐based peer support improves self‐care ability, compliance with attending scheduled follow‐up visits, and reduces postoperative anxiety and depression more effectively than conventional nurse care among patients with cardiac pacemaker implantation.

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Evaluation of patients' quality of life aspects after cardiac pacemaker implantation

Cited by 30 publications

References 23 publications

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

Dual-chamber pacemakers for treating symptomatic bradycardia due to sick sinus syndrome without atrioventricular block: a systematic review and economic evaluation

D Tipo Asmenybių Su Implantuotu Elektrokardiostimuliatoriumi Gyvenimo Kokybės Aspektai

Effect of peer support on health outcomes in patients with cardiac pacemaker implantation: A randomized, controlled trial

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