Psychological Effects of Implantable Cardioverter‐Defibrillator Leads under Advisory

Abstract

Our study attempts to address some of the psychological differences between participants with advisory and nonadvisory leads. Higher scores on the ICDC were found in our advisory group. While statistically significant, it is entirely unclear if these scale elevations are clinically significant or if directed counseling at this stage may reduce these elevations. This raises the suspicion that directed counseling be undertaken for patients with future advisories.

Determinants and trajectory of phobic anxiety in patients living with an implantable cardioverter defibrillator

“…Patients with a high-risk psychological profile may have a tendency to interpret ICD shocks as relatively more malignant, suggesting that it is not the actual shock that leads to distress but more the patient's appraisal and interpretation of the shock 31. This association of the presence of any shock is consistent with an earlier study dealing with leads under advisory,32 which was not the case for our ICD patients.…”

Perspectives of patients with cardiovascular implantable electronic devices who received advisory warnings

“…The patients in our study reported a range of emotional responses to the advisories that affected them—from no concern to feeling “outraged” and “terrified.” Concern, however, was the most common sentiment. The perspectives of patients in our study reflect, in part, the results of prior quantitative studies, which showed varied psychological effects of CIED advisories on affected patients (10,12,14,15). These results suggest that clinicians who care for patients with CIEDs be prepared for patients’ emotional responses to advisories.…”

“…One study assessed anxiety before and after CIED advisory (12). Several studies showed that patients with CIEDs affected by advisories experienced higher levels of anxiety, ICD concerns, and distress than patients with CIEDs unaffected by advisories (10,12,14,15). In the other studies, device advisories had no adverse psychological impact on affected patients (9,11,13,16,17).…”

Biventricular Defibrillator Patients Have Higher Complication Rates after Revision of Recalled Leads

“…In early 2009, Medtronic issued a revised statement noting an increased rate of Sprint Fidelis® lead failure (3.9–5.8% failure at 45 months) 1,2 . Lead failure rate has continued to rise and has led to increasing concerns among patients and their caring physicians 3,4 . In light of the increasing failure rate, many implanting physicians opted to take a more aggressive approach to lead management and revise these leads prophylactically 5 …”