Repeated defibrillation shocks from an ICD were significantly related to the development of anxiety disorders, which occurred in 15.9% of patients 1 to 6 years post-implantation.
Cohort (n=72)
Do repeated ICD shocks increase the risk of developing anxiety disorders in patients with an implantable cardioverter/defibrillator?
Repeated ICD shocks are significantly associated with the development of anxiety disorders, supporting a classic conditioning model of anxiety in this patient population.
OBJECTIVE: A model for the development of anxiety disorders (panic disorder with or without agoraphobia) is needed. Patients with an implantable cardioverter/defibrillator (ICD) are exposed to repeated electric shocks. If the theory of anxiety development by aversive classic conditioning processes is valid, these repeated shocks should lead to an increased risk of anxiety disorders. To study this hypothesis, we retrospectively studied 72 patients after implantation of an automatic ICD. METHODS: Patients were assessed with the semistructured Diagnostic Interview of Psychiatric Disease 1 to 6 years after implantation of an automatic ICD. Panic disorder and/or agoraphobia was diagnosed in patients who fulfilled all DSM-III-R criteria for those conditions. RESULTS: Anxiety disorder developed in 15.9% of patients after ICD implantation. This was significantly related to the frequency of repeated defibrillation (shocks) to stop malignant ventricular arrhythmias. Dysfunctional cognitions are an additional vulnerability factor. CONCLUSIONS: The data support both the conditioning hypothesis and the cognitive model of anxiety development. These findings suggest that ICD patients are an appropriate risk population for a prospective study of the development of anxiety disorders.
Godemann et al. (Thu,) conducted a cohort in Implantable cardioverter/defibrillator (ICD) patients (n=72). Repeated defibrillation (shocks) was evaluated on Development of anxiety disorder (panic disorder and/or agoraphobia). Repeated defibrillation shocks from an ICD were significantly related to the development of anxiety disorders, which occurred in 15.9% of patients 1 to 6 years post-implantation.
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