Quality of Life in Patients with an Implantable Cardioverter Defibrillator: A Systematic Review

Abstract

Despite the indisputable mortality advantages of implantable cardioverter defibrillators (ICDs), no consensus exists regarding their impact on quality of life (QoL). This systematic review investigates differences in QoL between patients with ICDs and controls. We systematically searched the MEDLINE, EMBASE, Cochrane, Web of Science, and PsychINFO databases. Articles were included if they were published after the year 2000 and reported on original studies with a control group. Five randomized controlled trials with a total of 5,138 patients and 10 observational studies with a total of 1,513 patients met the inclusion criteria. Nine studies found comparable QoL for ICD recipients and patients in the control groups, three studies found an increased QoL for ICD patients, and three studies found a decreased QoL for ICD patients. The question of whether QoL relates to ICD therapy cannot be answered conclusively due to the heterogeneity of the existing studies. Lower QoL was apparent among patients with an ICD who experienced several device discharges. Medical staff should be particularly aware of the signs of both psychological and physical disorders in these patients. Further investigations on QoL in ICD patients are desirable, but ethical reasons restrict the conduct of randomized trials.

“Hosting” an implantable cardioverter defibrillator: A phenomenological inquiry

“…Our results underline how insight into the experience of ICD recipients is important to understanding patients' perception of living with that device. Controlled studies on quality of life in these patients have failed to ascertain causal effects related to the presence of the device (Tomzik, Koltermann, Zabel, Willich, & Reinhold, ), but qualitative approaches have revealed overlapping truths that, regardless of cultural or religious contexts, should be taken into account to improve the quality of patient care in the decision to implant and after ICD implantation (Kamphuis et al, ).…”

Combined Right Ventricular Outflow Tract Epicardial and Endocardial Late Potential Ablation for Treatment of Brugada Storm: A Case Report and Review of the Literature

“…Multiple ICD shocks, albeit appropriate, can be psychologically devastating to the patient [11, 12], may cause acute myocardial injury [13], myocardial dysfunction due to changes in transmembrane potential [14], and have pro-arrhythmic effects [15]. Medications such as quinidine may be effective in reducing ventricular arrhythmias in BrS patients, but adverse effects and drug–drug interactions may preclude their long-term use [3].…”

Impaired Mental Health‐Related Quality of Life in Patients with Idiopathic Ventricular Fibrillation

“…7 In addition, ICD patients in general, with both a primary and secondary prevention indication, report a normal HRQoL. 9 Therefore, the impaired mental HRQoL in iVF patients as shown in our study is striking.…”

“…Although results in cardiac arrest survivors are heterogeneous, a recent meta‐analysis showed that the majority of cardiac arrest survivors report a good HRQoL . In addition, ICD patients in general, with both a primary and secondary prevention indication, report a normal HRQoL . Therefore, the impaired mental HRQoL in iVF patients as shown in our study is striking.…”

“…However, the majority of cardiac arrest survivors report a normal health‐related quality of life (HRQoL) . ICD patients in general also report a normal HRQoL that is comparable with the healthy population, although approximately one in four patients report clinically relevant symptoms of anxiety and depression in the first year after implantation . Until now, no data are available regarding the HRQoL in patients with iVF.…”