Health-related quality of life and psychological distress in implantable cardioverter defibrillator patients with and without heart failure

Abstract

Heart failure (HF) is one of the major health concerns worldwide due to high incidence and mortality. HF patients experience high level of psychological distress, particularly anxiety and depression. To increase survival rate, implantable cardioverter defibrillator (ICD) acts as a life-savor to deliver immediate shock to correct life-threatening arrhythmias as HF patients are the high-risk population for sudden cardiac arrest. It was attributed to unpredictable ICD shock. Moreover, some studies reported that ICD can improve health-related quality of life (HRQoL) among HF patients. However, ICD was evidenced to increase anxiety and depression. Psychological distress can also impair HRQoL of ICD patients. Due to different health conditions and health needs, ICD patients with and without HF can perceive different degrees of heightened psychological distress and declined HRQoL. Although the number of HF patients receiving ICD implantation has been increasing, inadequate knowledge is reported about their psychological status and HRQoL. To improve current ICD care to patients with and without HF, this study aimed to compare psychological status (anxiety and depression) and HRQoL and identify the relationships of personal and clinical characteristics with psychological status and HRQoL between ICD patients with and without HF. A total of 139 ICD patients were recruited, including 68 patients with HF. Those with HF perceived relatively higher depression and poorer physical HRQoL. Patients without HF who were married perceived better physical and mental health. Patients with HF who were more dependent have heightened anxiety and depression. The results shed light on the differences from the level of anxiety and depression among ICD patients with and without HF as well as their HRQoL so that ICD care for these two specific ICD patient groups can be directed. Family involvement is more significant for patients with and without HF. KeywordsImplantable cardioverter defibrillator, heart failure, psychological distress, health-related quality of life