People With Implantable Defibrillators May Need More Mental Health Support

WEDNESDAY Sept. 26, 2012 -- Depression, anxiety and post-traumatic stress disorder are common among people with implanted heart defibrillators, but improved patient education and ongoing psychological support can help them cope.

That's the message in a new scientific statement from the American Heart Association.

An implantable cardioverter defibrillator (ICD) restores normal heart rhythm and prevents sudden cardiac death.

"A shock from an ICD can be lifesaving, but it can also affect a person's quality of life and psychological state," statement writing group chair Sandra Dunbar said in an AHA news release. "It's important to look at this issue now because 10,000 people have an ICD implanted each month. They range from older people with severe heart failure to healthy children who have a gene that increases the risk of sudden cardiac arrest."

Before they receive an implantable defibrillator, patients should be provided with clear information about the benefits and limitations of the device, their prognosis, and the impact it will have on their lifestyle, including activity and work, the statement recommends.

Patients with implantable defibrillators should undergo regular screening and receive appropriate treatment for anxiety, depression and PTSD.

The statement recommends that doctors and nurses should:

  • Ensure that patients understand that the ICD protects against sudden death but does not improve their underlying heart condition unless the device does other things, such as certain types of pacing.
  • Assess patients' concerns and psychological status at each follow-up visit.
  • Develop a clear plan so that patients and family members know what to do if an ICD delivers a shock to correct heart rhythm.
  • Provide gender-specific, age-appropriate information for children and their families.

"Experiencing a shock is distressing and patients have a wide variety of responses," Dunbar said. "Some find it very reassuring that it's working, while others find the actual physical sensations frightening and overwhelming. That's why we suggest that clinicians provide an ongoing assessment of ICD patients' psychological needs."

The statement was published in the Sept. 24 issue of the journal Circulation.

More information

The Heart Rhythm Society has more about implantable cardioverter defibrillators.

Posted: September 2012


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