Educational and Psychological Interventions to Improve Outcomes for Recipients of Implantable Cardioverter Defibrillators and Their Families: A Scientific Statement From the American Heart Association
Open accessAbstract
Significant mortality benefits have been documented in recipients of implantable cardioverter defibrillators (ICDs); however, the psychosocial distress created by the underlying arrhythmia and its potential treatments in patients and family members may be underappreciated by clinical care teams. The disentanglement of cardiac disease and device-related concerns is difficult. The majority of ICD patients and families successfully adjust to the ICD, but optimal care pathways may require additional psychosocial attention to all ICD patients and particularly those experiencing psychosocial distress. This state-of-the-science report was developed on the basis of an analysis and critique of existing science to (1) describe the psychological and quality-of-life outcomes after receipt of an ICD and describe related factors, such as patient characteristics; (2) describe the concerns and educational/informational needs of ICD patients and their family members; (3) outline the evidence that supports interventions for improving educational and psychological outcomes for ICD patients; (4) provide recommendations for clinical approaches for improving patient outcomes; and (5) identify priorities for future research in this area. The ultimate goal of this statement is to improve the precision of identification and care of psychosocial distress in ICD patients to maximize the derived benefit of the ICD.
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The incidence of anxiety and depression is higher in the ICD population than in other cardiac populations.
“The incidence of anxiety and depression is higher in the ICD population than in other cardiac populations.7”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [7]
It is likely that many factors, such as baseline psychological traits and social support, interact with shock to impact whether patients develop anxiety, depression, or posttraumatic stress disorder.
“As with QOL, it is likely that many factors, such as baseline psychological traits and social support, interact with shock to impact whether patients develop anxiety, depression, or posttraumatic stress disorder.7,15”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [7]
The importance of psychoeducational interventions reported to date to improve quality of life and mood disturbances in ICD patients has been recently reviewed.
“The importance of psychoeducational interventions, 15 reported to date, to improve QOL and mood disturbances in ICD patients has been recently reviewed.7”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [7]
Most psychoeducational interventions have included in-person or telephone interventions with cognitive behavioral therapy frameworks, which have shown improvements in anxiety, depression, and posttraumatic stress disorder, although sample sizes have been small.
“Most have included in-person or telephone interventions with the use of cognitive behavioral therapy frameworks, which have shown improvements in anxiety, depression, and posttraumatic stress disorder, although sample sizes have been small.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [7]
Poor patient-reported outcomes may in part be attributed to shocks and fear of shocks, which may lead to avoidance behaviours, a sedentary lifestyle, and sexual problems.
“Poor patient-reported outcomes may in part be attributed to shocks and fear of shocks [8, 9], which may lead to avoidance behaviours, a sedentary lifestyle, and sexual problems. [10]”
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References 234 · Cited by 221
Research works printed but not linked: 4
- [7]7. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, Domanski M, Troutman C, Anderson J, Johnson G, McNulty SE, Clapp- Channing N, Davidson-Ray LD, Fraulo ES, Fishbein DP, Luceri RM, Ip JH; Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investi- gators. Amiodarone or an implantable cardioverter-defibrillator for con- gestive heart failure [published correction appears in N Engl J Med. 2005;352:2146]. N Engl J Med. 2005:225-237.
- [53]53. Dunbar SB, Kimble LP, Jenkins LS, Hawthorne M, Dudley W, Slemmons M, Langberg JJ. Association of mood disturbance and ar- rhythmia events in patients after cardioverter defibrillator implantation. Depress Anxiety. 1999;9:163-186.
- [69]69. Vazquez LD, Conti JB, Sears SF. Female-specific education, man- agement, and lifestyle enhancement for implantable cardioverter defi- brillator patients: the FEMALE-ICD study. Pacing Clin Electrophysiol. 2010;33:1131-1140.
- [120]120. Costa R, Silva KR, Mendonc ¸a RC, Nishioka SA, Siqueira SdF, Tamaki WT, Crevelari ES, Moreira LFP, Filho MM. Incidence of shock and quality of life in young patients with implantable cardioverter- defibrillator. Arq Bras Cardiol. 2007;88:258 -264.
- Authors
- Dunbar, S. B., Dougherty, C. M., Sears, S. F., Carroll, D. L., Goldstein, N. E., Mark, D. B., McDaniel, G., Pressler, S. J., Schron, E., Wang, P., & Zeigler, V. L.
- Affiliations
- American Heart Association (US)
- ORCID
- Venue
- Circulation
- Published
- 2012-10-23
- Volume
- 126
- Issue
- 17
- Pages
- 2146-2172
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1970148707
- Semantic Scholar
- 15785c0cfe838b6c18e0774a95125408728d4530
- Cited by
- 221
- References
- 234
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 12 · 2023: 7 · 2022: 15 · 2021: 16 · 2020: 13 · 2019: 17 · 2018: 20 · 2017: 26 · 2016: 21 · 2015: 21 · 2014: 22 · 2013: 15 · 2012: 2
- FWCI
- 12.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- Sanofi
- Massachusetts General Hospital
- Gilead Sciences
- Alexion Pharmaceuticals
- Emory University
- University of Washington
- Boston Scientific Corporation
- Medicure
- National Institutes of Health
- St. Jude Medical
- National Heart, Lung, and Blood Institute
- 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 › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- implantable cardioverter-defibrillator, psychosocial distress, quality of life, patient education, family caregivers, cardiac arrhythmias, psychological intervention, patient outcomes, care pathways
- MeSH terms
- American Heart Association, Family, Humans, Patient Education as Topic, United States, Treatment Outcome, Defibrillators, Implantable, Practice Guidelines as Topic
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