Cited by 110Cardiac Health and Mental HealthCardiac pacing and defibrillation studiesCardiac electrophysiology and arrhythmias

Risk of Ventricular Arrhythmia After Implantable Defibrillator Treatment in Anxious Type D Patients

Open access
van den Broek, Krista C., Nyklíček, Ivan, van der Voort, Pepijn H., Alings, Marco, Meijer, Albert, Denollet, Johan·2009·Journal of the American College of Cardiology

Abstract

Objectives We sought to examine the combination of adverse psychological factors (anxiety, depression, and distressed or Type D personality) as a predictor of ventricular arrhythmias in patients with implantable cardioverter-defibrillators (ICDs).Background Little is known about the role of psychological factors and their clustering in the occurrence of life-threatening arrhythmias.Methods In this prospective study, 391 patients with an ICD (81% men, age 62.3 +/- 10.4 years) completed anxiety, depression, and Type D personality scales at the time of implantation. The end point was occurrence of ventricular arrhythmia, defined as appropriate ICD therapies, in the first year after implantation.Results Ventricular arrhythmias occurred in 19% (n = 75) of patients. Increased symptoms of depression (p = 0.81) or anxiety (p = 0.31) did not predict arrhythmias. However, anxious patients with a Type D personality had a significantly increased rate of ventricular arrhythmias (21 of 71; 29.6%) as compared with other ICD patients (54 of 320; 16.9%; hazard ratio [HR]: 1.89; 95% confidence interval [CI]: 1.14 to 3.13; p = 0.013). When controlled for the effects of sex, age, ischemic etiology, left ventricular dysfunction, prolonged QRS duration, and medication, anxious Type D patients (HR: 1.72; 95% CI: 1.03 to 2.89; p = 0.039) and secondary prevention patients (HR: 1.91; 95% CI: 1.14 to 3.20; p = 0.014) were at increased risk of ventricular arrhythmias.Conclusions Personality modulated the effect of emotional distress; anxiety predicted a 70% increase in risk of arrhythmia in Type D patients but not in other patients. Anxious Type D patients may be identified and offered additional behavioral support after ICD implantation.

Integrity signals

Registry

Crossref · 10.1016/j.jacc.2009.04.043

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
van den Broek, K. C., Nyklíček, I., van der Voort, P. H., Alings, M., Meijer, A., & Denollet, J.
Affiliations
  • Tilburg University (NL)
  • Amphia Ziekenhuis (NL)
  • Catharina Ziekenhuis (NL)
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2009-08
Volume
54
Issue
6
Pages
531-537
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2068137454
Cited by
110
References
58
Citations by year
2025: 2 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 8 · 2016: 7 · 2015: 6 · 2014: 5 · 2013: 11 · 2012: 18
FWCI
10.61
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • Research portal (Tilburg University) (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Nederlandse Organisatie voor Wetenschappelijk Onderzoek (453-04-004)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
ventricular arrhythmias, implantable cardioverter-defibrillator, Type D personality, anxiety, depression, psychological distress, personality traits, appropriate ICD shocks, secondary prevention, behavioral support
MeSH terms
Aged, Anxiety Disorders, Arrhythmias, Cardiac, Depressive Disorder, Female, Humans, Male, Middle Aged, Personality, Risk Factors, Defibrillators, Implantable

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review