Anxiety and risk of ventricular arrhythmias or mortality in patients with an implantable cardioverter defibrillator

M. Habibovic, S.S. Pedersen, K.C. van den Broek, D.A.M.J. Theuns, L. Jordaens, P.H.J. van der Voort, M. Alings, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective:
A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences anxiety after device implantation. The purpose of the present study was to evaluate whether anxiety is predictive of ventricular arrhythmias and all-cause mortality 1 year post ICD implantation.
Methods:
A total of 1012 patients completed the state version of the State-Trait Anxiety Inventory at baseline. The end points were ventricular arrhythmias and mortality the first year after ICD implantation.
Results:
Within the first year after ICD implantation, 19% of patients experienced a ventricular arrhythmia, and 4% died. Anxiety was associated with an increased risk of ventricular arrhythmias (hazard ratio [HR] = 1.017; 95% confidence interval [CI] = 1.005–1.028; p = .005) and mortality (HR = 1.038; 95% CI = 1.014–1.063; p = .002) in adjusted analysis. Patients with anxiety (highest tertile) had a 1.9 increased risk for ventricular arrhythmias (95% CI = 1.329–2.753; p =.001) and a 2.9 increased risk for mortality (95% CI = 1.269–6.677; p = .01) compared with patients with low anxiety (lowest tertile). Among 257 patients with cardiac resynchronization therapy, anxiety was associated with mortality (HR = 5.381; 95% CI = 1.254–23.092; p = .02) after adjusting for demographic and clinical covariates.
Conclusions:
Anxiety was associated with an increased risk of ventricular arrhythmias and mortality 1 year after ICD implantation, independent of demographic and clinical covariates. Monitoring and treatment of anxiety may be warranted in a selected subgroup of high-risk patients with an ICD.
Original languageEnglish
Pages (from-to)36-41
JournalPsychosomatic Medicine
Volume75
Issue number1
DOIs
Publication statusPublished - 2013

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Implantable Defibrillators
Confidence Intervals
Equipment and Supplies

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Habibovic, M. ; Pedersen, S.S. ; van den Broek, K.C. ; Theuns, D.A.M.J. ; Jordaens, L. ; van der Voort, P.H.J. ; Alings, M. ; Denollet, J. / Anxiety and risk of ventricular arrhythmias or mortality in patients with an implantable cardioverter defibrillator. In: Psychosomatic Medicine. 2013 ; Vol. 75, No. 1. pp. 36-41.
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abstract = "Objective: A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences anxiety after device implantation. The purpose of the present study was to evaluate whether anxiety is predictive of ventricular arrhythmias and all-cause mortality 1 year post ICD implantation.Methods: A total of 1012 patients completed the state version of the State-Trait Anxiety Inventory at baseline. The end points were ventricular arrhythmias and mortality the first year after ICD implantation.Results: Within the first year after ICD implantation, 19{\%} of patients experienced a ventricular arrhythmia, and 4{\%} died. Anxiety was associated with an increased risk of ventricular arrhythmias (hazard ratio [HR] = 1.017; 95{\%} confidence interval [CI] = 1.005–1.028; p = .005) and mortality (HR = 1.038; 95{\%} CI = 1.014–1.063; p = .002) in adjusted analysis. Patients with anxiety (highest tertile) had a 1.9 increased risk for ventricular arrhythmias (95{\%} CI = 1.329–2.753; p =.001) and a 2.9 increased risk for mortality (95{\%} CI = 1.269–6.677; p = .01) compared with patients with low anxiety (lowest tertile). Among 257 patients with cardiac resynchronization therapy, anxiety was associated with mortality (HR = 5.381; 95{\%} CI = 1.254–23.092; p = .02) after adjusting for demographic and clinical covariates.Conclusions: Anxiety was associated with an increased risk of ventricular arrhythmias and mortality 1 year after ICD implantation, independent of demographic and clinical covariates. Monitoring and treatment of anxiety may be warranted in a selected subgroup of high-risk patients with an ICD.",
author = "M. Habibovic and S.S. Pedersen and {van den Broek}, K.C. and D.A.M.J. Theuns and L. Jordaens and {van der Voort}, P.H.J. and M. Alings and J. Denollet",
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Anxiety and risk of ventricular arrhythmias or mortality in patients with an implantable cardioverter defibrillator. / Habibovic, M.; Pedersen, S.S.; van den Broek, K.C.; Theuns, D.A.M.J.; Jordaens, L.; van der Voort, P.H.J.; Alings, M.; Denollet, J.

In: Psychosomatic Medicine, Vol. 75, No. 1, 2013, p. 36-41.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Anxiety and risk of ventricular arrhythmias or mortality in patients with an implantable cardioverter defibrillator

AU - Habibovic, M.

AU - Pedersen, S.S.

AU - van den Broek, K.C.

AU - Theuns, D.A.M.J.

AU - Jordaens, L.

AU - van der Voort, P.H.J.

AU - Alings, M.

AU - Denollet, J.

PY - 2013

Y1 - 2013

N2 - Objective: A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences anxiety after device implantation. The purpose of the present study was to evaluate whether anxiety is predictive of ventricular arrhythmias and all-cause mortality 1 year post ICD implantation.Methods: A total of 1012 patients completed the state version of the State-Trait Anxiety Inventory at baseline. The end points were ventricular arrhythmias and mortality the first year after ICD implantation.Results: Within the first year after ICD implantation, 19% of patients experienced a ventricular arrhythmia, and 4% died. Anxiety was associated with an increased risk of ventricular arrhythmias (hazard ratio [HR] = 1.017; 95% confidence interval [CI] = 1.005–1.028; p = .005) and mortality (HR = 1.038; 95% CI = 1.014–1.063; p = .002) in adjusted analysis. Patients with anxiety (highest tertile) had a 1.9 increased risk for ventricular arrhythmias (95% CI = 1.329–2.753; p =.001) and a 2.9 increased risk for mortality (95% CI = 1.269–6.677; p = .01) compared with patients with low anxiety (lowest tertile). Among 257 patients with cardiac resynchronization therapy, anxiety was associated with mortality (HR = 5.381; 95% CI = 1.254–23.092; p = .02) after adjusting for demographic and clinical covariates.Conclusions: Anxiety was associated with an increased risk of ventricular arrhythmias and mortality 1 year after ICD implantation, independent of demographic and clinical covariates. Monitoring and treatment of anxiety may be warranted in a selected subgroup of high-risk patients with an ICD.

AB - Objective: A subgroup of patients with an implantable cardioverter defibrillator (ICD) experiences anxiety after device implantation. The purpose of the present study was to evaluate whether anxiety is predictive of ventricular arrhythmias and all-cause mortality 1 year post ICD implantation.Methods: A total of 1012 patients completed the state version of the State-Trait Anxiety Inventory at baseline. The end points were ventricular arrhythmias and mortality the first year after ICD implantation.Results: Within the first year after ICD implantation, 19% of patients experienced a ventricular arrhythmia, and 4% died. Anxiety was associated with an increased risk of ventricular arrhythmias (hazard ratio [HR] = 1.017; 95% confidence interval [CI] = 1.005–1.028; p = .005) and mortality (HR = 1.038; 95% CI = 1.014–1.063; p = .002) in adjusted analysis. Patients with anxiety (highest tertile) had a 1.9 increased risk for ventricular arrhythmias (95% CI = 1.329–2.753; p =.001) and a 2.9 increased risk for mortality (95% CI = 1.269–6.677; p = .01) compared with patients with low anxiety (lowest tertile). Among 257 patients with cardiac resynchronization therapy, anxiety was associated with mortality (HR = 5.381; 95% CI = 1.254–23.092; p = .02) after adjusting for demographic and clinical covariates.Conclusions: Anxiety was associated with an increased risk of ventricular arrhythmias and mortality 1 year after ICD implantation, independent of demographic and clinical covariates. Monitoring and treatment of anxiety may be warranted in a selected subgroup of high-risk patients with an ICD.

U2 - 10.1097/PSY.0b013e3182769426

DO - 10.1097/PSY.0b013e3182769426

M3 - Article

VL - 75

SP - 36

EP - 41

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 1

ER -