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Quality of Life in the Antiarrhythmics Versus Implantable Defibrillators Trial: Impact of Therapy and Influence of Adverse Symptoms and Defibrillator Shocks
Abstract
Background — Implantable cardioverter defibrillator (ICD) use reduces mortality in patients with serious ventricular arrhythmias compared with antiarrhythmic drug (AAD) use. However, the relative impact of these therapies on self-perceived quality of life (QoL) is unknown. Methods and Results — Three self-administered instruments were used to measure generic and disease-specific QoL in Antiarrhythmics Versus Implantable Defibrillators trial participants. Generalized linear models were used to assess the relationships between self-perceived QoL and treatment (AAD versus ICD) and adverse symptoms and ICD shocks. To minimize the impact of missing data, only patients surviving 1 year were included in the primary analyses. Baseline characteristics among QoL participants (n=905) and nonparticipants (n=111) were similar, but participants who survived 1 year (n=800) were healthier at baseline than nonsurvivors (n=105). Of the 800 patients in the primary analysis, characteristics of those randomized to AAD (n=384) versus ICD (n=416) were similar. Overall, ICD and AAD use were associated with similar alterations in QoL. The development of sporadic shocks and adverse symptoms were each associated with reduced physical functioning and mental well-being and increased concerns among ICD recipients, whereas development of adverse symptoms was associated with reduced physical functioning and increased concerns among AAD recipients. Conclusions — ICD and AAD therapy are associated with similar alterations in self-perceived QoL over 1-year follow-up. Adverse symptoms were associated with reduced self-perceived QoL in both groups, and sporadic shocks were associated with reduced QoL in ICD recipients.
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“Further, there was greater reduction in QOL as the number of shocks increased.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [5]
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“In the Antiarrhythmics Versus Implanted Defibrillators (AVID) trial, baseline QOL measured by SF-36 in ICD patients was similar to that of elderly patients with recent myocardial infarction or severe heart failure, but less than for ambulatory patients with heart failure”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [5]
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“Similarly, in the AVID trial, 5 the occurrence of even 1 shock was associated with a reduction in mental well-being and physical function, even after controlling for multiple clinical factors such as heart failure, index arrhythmia, and ejection fraction.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [5]
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“As described above, many studies suggest that ICD shocks can decrease QOL.96”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [96]
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Self-citation
Metadata
- Authors
- Schron, E. B., Exner, D. V., Yao, Q., Jenkins, L. S., Steinberg, J. S., Cook, J. R., Kutalek, S. P., Friedman, P. L., Bubien, R. S., Page, R. L., Powell, J., & the AVID Investigators
- Affiliations
- University of Maryland, Baltimore (US)
- Venue
- Circulation
- Published
- 2002-02-05
- Volume
- 105
- Issue
- 5
- Pages
- 589-594
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2101541776
- Semantic Scholar
- 216ffa4eb6d0222f0b0b6ea03afb7c4d6d95a1c3
- Cited by
- 624
- References
- 39
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 11 · 2023: 16 · 2022: 14 · 2021: 26 · 2020: 19 · 2019: 26 · 2018: 17 · 2017: 27 · 2016: 31 · 2015: 36 · 2014: 24 · 2013: 27 · 2012: 39
- FWCI
- 13.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fondation pour la Recherche Médicale
- National Institutes of Health (n01hc025117-014)
- Canadian Institutes of Health Research
- National Heart, Lung, and Blood Institute (N01-HC-25117)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- quality of life, implantable cardioverter-defibrillator, antiarrhythmic drugs, ventricular arrhythmias, ICD shocks, adverse symptoms, physical function, psychological well-being, patient concerns
- MeSH terms
- Aged, Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Demography, Electric Countershock, Electrocardiography, Female, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Treatment Outcome, Defibrillators, Implantable
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