A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety

Qintar, Mohammed; George, Jason J.; Panko, Melanie; Bea, Scott; Broer, Karen; John, Julie St.; Blissett, Kecia Ann; Ching, Elizabeth; Sears, Samuel F.; Pedersen, Susanne S.; Pozuelo, Leopoldo; Chung, Mina K.

doi:10.1007/s10840-015-9990-7

Cited by 28 publications

(23 citation statements)

References 36 publications

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“…Findings over the past 13 years confirm initial psychometric analyses that found FSAS to be a reliable and valid measure of ICD shock anxiety . The most frequently reported predictors of FSAS‐measured shock anxiety include the occurrence and number of shocks (appropriate and inappropriate), with a dose‐response relationship such that greater number of shocks is linked to higher FSAS scores . However, FSAS results have also been linked to increases in antitachycardia pacing, indicating that shock anxiety increases even in the absence of actual shock but the presence of increased awareness of shock possibility .…”

Section: Discussionsupporting

confidence: 59%

“…FSAS scores may be a useful barometer of treatment response, as ICD‐specific cognitive–behavioral interventions in small samples have been associated with decreased FSAS scores . However, there have been inconsistent results on the short‐term and long‐term efficacy of ICD‐specific web‐based psychological and educational interventions for reducing ICD‐related distress, including FSAS score …”

Section: Resultsmentioning

confidence: 99%

“…Although not developed specifically for this purpose, research on FSAS suggests that it may be a viable measure for monitoring and tracking treatment response to cognitive–behavioral interventions and education‐based interventions . As such, tools like FSAS may help foster measurement‐based care in cardiac psychology; this is a critical component of high‐quality, evidence‐based service delivery that is sorely needed.…”

Section: Discussionmentioning

confidence: 99%

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Measuring ICD shock anxiety: Status update on the Florida Shock Anxiety Scale after over a decade of use

Tripp

Huber

Kuhl³

et al. 2019

Pacing Clinical Electrophis

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Introduction Approximately 44% of patients with implantable cardioverter defibrillators (ICDs) experience some form of shock anxiety, associated with cardiac fear, physical inactivity, and increased morbidity and mortality. The Florida Shock Anxiety Scale (FSAS) was created to measure ICD‐specific fears for a more precise target of patient psychologic distress and potential need for intervention. The current paper describes results from a focused literature review of studies using FSAS over the past 15 years, with the aim of summarizing its current reliability and validity, associated outcomes, and potential future directions for its clinical and research implementation. Methods In this review, 26 peer‐reviewed articles were analyzed and selected from an in‐depth literature search of two electronic databases. Results The reliability and validity of FSAS has been upheld since its initial validation and remain positive. The majority of studies used FSAS as an assessment tool to evaluate a clinical need for psychologic support or psychoeducation. The most frequently reported predictors of FSAS shock anxiety include experience of shock, appropriate and inappropriate, and number of shocks experienced. Common correlates of higher FSAS scores include lower device‐related knowledge, lower perceived support from healthcare providers, greater posttraumatic stress disorder symptoms, and negative attitudes about device dependency. Younger age and female gender are also associated with increased shock anxiety. Conclusions Since 2006, FSAS has been widely represented as a valid and reliable assessment tool for quantifying device‐related anxiety in ICD recipients in diverse populations. Future directions for FSAS should explore its potential role in support of measurement‐based care.

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Section: Discussionsupporting

confidence: 59%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Measuring ICD shock anxiety: Status update on the Florida Shock Anxiety Scale after over a decade of use

Tripp

Huber

Kuhl³

et al. 2019

Pacing Clinical Electrophis

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“…Significant differences were found after three CBT sessions. 26 All interventional trials were small and the intervention was very short. No trial has tested a set-up with screening, identification of type of anxiety using Diagnostic and Statistical Manual of Mental Disorders (DSM) 27 criteria and a longer lasting intervention, based on current recommendations.…”

Section: Introduction Background and Rationalementioning

confidence: 99%

The Screen-ICD trial. Screening for anxiety and cognitive therapy intervention for patients with implanted cardioverter defibrillator (ICD): a randomised controlled trial protocol

et al. 2016

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IntroductionPrevious research shows that patients with an implanted cardioverter defibrillator (ICD) have a fourfold increased mortality risk when suffering from anxiety compared with ICD patients without anxiety. This research supports the screening of ICD patients for anxiety with the purpose of starting relevant intervention.Methods and analysisScreen-ICD consists of 3 parts: (1) screening of all hospitalised and outpatient patients at two university hospitals using the Hospital Anxiety and Depression Scale (HADS), scores ≥8 are invited to participate. (2) Assessment of type of anxiety by Structured Clinical Interview for DSM Disorders (SCID). (3) Investigator-initiated randomised clinical superiority trial with blinded outcome assessment, with 1:1 randomisation to cognitive–behavioural therapy (CBT) performed by a cardiac nurse with CBT training, plus usual care or usual care alone. The primary outcome is HADS-A measured at 16 weeks. Secondary outcomes include Becks Anxiety Inventory, HeartQoL, Hamilton Anxiety Scale, heart rate variability, ICD shock, time to first shock and antitachycardia pacing. A total of 88 participants will be included. The primary analyses are based on the intention-to-treat principle and we use a mixed model with repeated measurements for continuous outcomes. For binary outcomes (HADS-A score <8), we use a generalised mixed model with repeated measurements.Ethics and disseminationThe trial is performed in accordance with the Declaration of Helsinki. All patients must give informed consent prior to participation and the trial is initiated after approval by the Danish Data Protection Agency (RH-2015-282) and the regional ethics committee (H-16018868). Positive, neutral and negative results of the trial will be published.Trial registration numberNCT02713360.

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“…Researchers have also studied the effect of device acceptance, perceived support from healthcare professionals, race (African Americans scoring higher on FSAS), and number of shocks experienced (appropriate or inappropriate). Moreover, secondary prevention was a consistent risk factor across multiple studies . The success of the FSAS even prompted the validation of a German version by Ritzka et al, which again showed the importance of both consequence and trigger stimuli .…”

mentioning

confidence: 97%

The utility of the Florida Shock Anxiety Scale: What have we learned?

Jalloul

Refaat

2019

Pacing Clinical Electrophis

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A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety

Abstract: ClinicalTrials.gov identifier: NCT00851071. URL: http://clinicaltrials.gov/ct2/show/NCT00851071?term=anxiety+in+icd+patients+cleveland+clinic&rank=1.

Cited by 28 publications

References 36 publications

Measuring ICD shock anxiety: Status update on the Florida Shock Anxiety Scale after over a decade of use

Measuring ICD shock anxiety: Status update on the Florida Shock Anxiety Scale after over a decade of use

The Screen-ICD trial. Screening for anxiety and cognitive therapy intervention for patients with implanted cardioverter defibrillator (ICD): a randomised controlled trial protocol

The utility of the Florida Shock Anxiety Scale: What have we learned?

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