Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation

S.S. Pedersen, M.T. Hoogwegt, L. Jordaens, D.A.M.J. Theuns

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Abstract

Background
The impact of ICD therapy on patient well being has typically focused on mean differences between groups, thereby neglecting changes within individuals. Using an intra-individual approach, we examined (i) the prevalence of implantable cardioverter defibrillator (ICD) patients maintaining their pre implantation level of psychological functioning at 12 months, and (ii) factors associated with deterioration in functioning.
Methods
Consecutively implanted ICD patients (n = 332) completed a set of standardized and validated patient reported measures at baseline and at 12 months post implantation.
Results
The majority of patients (72.8% to 81.7%) preserved their pre implantation level of psychological functioning 12 months post implantation. In adjusted analysis, ICD shock (all ps < .001) and Type D personality (all ps < .05) were independent predictors of deterioration in psychological functioning at 12 months across all domains, while baseline psychological status was associated with an improvement (all ps < .05). Patients with a primary prevention indication experienced a decrease in ICD concerns (p = .03) and anxiety (p = .006), and older patients (p = .04) a decrease in anxiety symptoms during the follow-up period. By contrast, patients with left ventricular dysfunction (p = .007) and atrial fibrillation (p = .02) were more likely to experience an increase in anxiety.
Conclusions
The majority of ICD patients maintained their pre implantation level of psychological functioning at 12 months. A subset of patients was at risk of poor psychological adaptation, attributable to ICD shocks, Type D personality, atrial fibrillation, and left ventricular dysfunction, while primary prevention indication and older age had a protective effect against deterioration in functioning.
Original languageEnglish
Pages (from-to)215-220
JournalInternational Journal of Cardiology
Volume166
Issue number1
DOIs
Publication statusPublished - 2013

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@article{93bd3d43c7c34c81b1cb62402f5d02d3,
title = "Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation",
abstract = "BackgroundThe impact of ICD therapy on patient well being has typically focused on mean differences between groups, thereby neglecting changes within individuals. Using an intra-individual approach, we examined (i) the prevalence of implantable cardioverter defibrillator (ICD) patients maintaining their pre implantation level of psychological functioning at 12 months, and (ii) factors associated with deterioration in functioning.MethodsConsecutively implanted ICD patients (n = 332) completed a set of standardized and validated patient reported measures at baseline and at 12 months post implantation.ResultsThe majority of patients (72.8{\%} to 81.7{\%}) preserved their pre implantation level of psychological functioning 12 months post implantation. In adjusted analysis, ICD shock (all ps < .001) and Type D personality (all ps < .05) were independent predictors of deterioration in psychological functioning at 12 months across all domains, while baseline psychological status was associated with an improvement (all ps < .05). Patients with a primary prevention indication experienced a decrease in ICD concerns (p = .03) and anxiety (p = .006), and older patients (p = .04) a decrease in anxiety symptoms during the follow-up period. By contrast, patients with left ventricular dysfunction (p = .007) and atrial fibrillation (p = .02) were more likely to experience an increase in anxiety.ConclusionsThe majority of ICD patients maintained their pre implantation level of psychological functioning at 12 months. A subset of patients was at risk of poor psychological adaptation, attributable to ICD shocks, Type D personality, atrial fibrillation, and left ventricular dysfunction, while primary prevention indication and older age had a protective effect against deterioration in functioning.",
author = "S.S. Pedersen and M.T. Hoogwegt and L. Jordaens and D.A.M.J. Theuns",
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Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation. / Pedersen, S.S.; Hoogwegt, M.T.; Jordaens, L.; Theuns, D.A.M.J.

In: International Journal of Cardiology, Vol. 166, No. 1, 2013, p. 215-220.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation

AU - Pedersen, S.S.

AU - Hoogwegt, M.T.

AU - Jordaens, L.

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

N1 - >2000 woorden

PY - 2013

Y1 - 2013

N2 - BackgroundThe impact of ICD therapy on patient well being has typically focused on mean differences between groups, thereby neglecting changes within individuals. Using an intra-individual approach, we examined (i) the prevalence of implantable cardioverter defibrillator (ICD) patients maintaining their pre implantation level of psychological functioning at 12 months, and (ii) factors associated with deterioration in functioning.MethodsConsecutively implanted ICD patients (n = 332) completed a set of standardized and validated patient reported measures at baseline and at 12 months post implantation.ResultsThe majority of patients (72.8% to 81.7%) preserved their pre implantation level of psychological functioning 12 months post implantation. In adjusted analysis, ICD shock (all ps < .001) and Type D personality (all ps < .05) were independent predictors of deterioration in psychological functioning at 12 months across all domains, while baseline psychological status was associated with an improvement (all ps < .05). Patients with a primary prevention indication experienced a decrease in ICD concerns (p = .03) and anxiety (p = .006), and older patients (p = .04) a decrease in anxiety symptoms during the follow-up period. By contrast, patients with left ventricular dysfunction (p = .007) and atrial fibrillation (p = .02) were more likely to experience an increase in anxiety.ConclusionsThe majority of ICD patients maintained their pre implantation level of psychological functioning at 12 months. A subset of patients was at risk of poor psychological adaptation, attributable to ICD shocks, Type D personality, atrial fibrillation, and left ventricular dysfunction, while primary prevention indication and older age had a protective effect against deterioration in functioning.

AB - BackgroundThe impact of ICD therapy on patient well being has typically focused on mean differences between groups, thereby neglecting changes within individuals. Using an intra-individual approach, we examined (i) the prevalence of implantable cardioverter defibrillator (ICD) patients maintaining their pre implantation level of psychological functioning at 12 months, and (ii) factors associated with deterioration in functioning.MethodsConsecutively implanted ICD patients (n = 332) completed a set of standardized and validated patient reported measures at baseline and at 12 months post implantation.ResultsThe majority of patients (72.8% to 81.7%) preserved their pre implantation level of psychological functioning 12 months post implantation. In adjusted analysis, ICD shock (all ps < .001) and Type D personality (all ps < .05) were independent predictors of deterioration in psychological functioning at 12 months across all domains, while baseline psychological status was associated with an improvement (all ps < .05). Patients with a primary prevention indication experienced a decrease in ICD concerns (p = .03) and anxiety (p = .006), and older patients (p = .04) a decrease in anxiety symptoms during the follow-up period. By contrast, patients with left ventricular dysfunction (p = .007) and atrial fibrillation (p = .02) were more likely to experience an increase in anxiety.ConclusionsThe majority of ICD patients maintained their pre implantation level of psychological functioning at 12 months. A subset of patients was at risk of poor psychological adaptation, attributable to ICD shocks, Type D personality, atrial fibrillation, and left ventricular dysfunction, while primary prevention indication and older age had a protective effect against deterioration in functioning.

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JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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