Influence of primary and secondary prevention indications on anxiety about the implantable cardioverter-defibrillator.
Influence of primary and secondary prevention indications on anxiety about the implantable cardioverter-defibrillator.
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DOI：
10.1016/j.joa.2015.10.002
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发表时间：
2016-04
影响因子：
2
通讯作者：
Chishaki H
中科院分区：
文献类型：
--
作者：
Rahmawati A;Chishaki A;Ohkusa T;Sawatari H;Tsuchihashi-Makaya M;Ohtsuka Y;Nakai M;Miyazono M;Hashiguchi N;Sakurada H;Takemoto M;Mukai Y;Inoue S;Sunagawa K;Chishaki H
植入式心律转复除颤器（ICD）已被确立用于致命性心律失常的一级和二级预防。然而，关于ICD适应症对生活质量（QOL）和心理障碍的影响知之甚少。本研究旨在检查植入ICD作为致命性心律失常一级或二级预防的患者在生活质量和心理困扰方面是否存在差异。一项对179例ICD植入的连续门诊患者（29.1%一级预防）进行的多中心调查完成了简明量表-8（SF-8）、贝克抑郁量表（BDI）、事件影响量表修订版（IES-R）、状态-特质焦虑量表（STAI）和ICD担忧量表（WAICD）。即使在调整人口统计学和临床特征后，植入ICD进行一级预防的患者的特质焦虑评分和对ICD评分的担忧也高于植入ICD进行二级预防的患者（分别为41.7± 12.4 vs. 34.7±12.3，p=0.001和39.6±18.0 vs. 30.0±18.9，p=0.002）。在多变量方差分析中，一级预防ICD接受者在SF-8的活力子量表上报告了较差的QOL。在我们的研究人群中，主要由纽约心脏协会（NYHA）I级和II级受试者组成，与二级预防ICD接受者相比，一级预防ICD接受者更容易经历对其ICD的担忧、焦虑和较差的QOL。在临床实践中，应密切监测一级预防ICD患者。如有必要，应给予心理干预，因为焦虑和低生活质量是死亡的预测因素。
Implantable cardioverter-defibrillators (ICDs) have been established for primary and secondary prevention of fatal arrhythmias. However, little is known about the influence of ICD indications on quality of life (QOL) and psychological disturbances. This study aimed to examine whether there were differences in QOL and psychological distress in patients that have an ICD for primary or secondary prevention of fatal arrhythmias. A multicenter survey of 179 consecutive outpatients (29.1% primary prevention) with ICD implantations completed the Short Form-8 (SF-8), Beck Depression Inventory (BDI), Impact of Event Scale-Revised (IES-R), State-Trait Anxiety Inventory (STAI), and Worries about ICD (WAICD). Patients with an ICD for primary prevention had a higher trait anxiety score and worries about ICD score than patients with an ICD for secondary prevention (41.7±12.4 vs. 34.7±12.3, p=0.001 and 39.6±18.0 vs. 30.0±18.9, p=0.002, respectively), even after adjusting for demographic and clinical characteristics. In multivariable analysis of variance, primary prevention ICD recipients reported a poorer QOL on the vitality subscale of the SF-8. In our study population, which mostly consisted of New York Heart Association (NYHA) class I and II subjects, primary prevention ICD recipients were more prone to experience worries about their ICD, anxiety, and a poorer QOL compared to secondary prevention ICD recipients. In clinical practice, primary prevention ICD patients should be closely monitored. If warranted, they should be offered psychological intervention, as anxiety and low QOL were predictors of mortality.