Health-related quality of life in in a large cohort of patients with cardiac implantable electronic devices – a registry based study

Abstract Aim The association of cardiac implantable electronic devices (CIED), namely pacemaker (PM), implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy with (CRT-D) or without defibrillator (CRT-P), on health-related quality of life (HRQoL) is lacking. Methods and results Data from the Swedish Pacemaker and ICD Registry together with the European Quality of Life-5 Dimension questionnaire (EQ-5D) administered before and after one year the CIED implant from January 2019 to February 2022 were used to analyze the HRQoL with the EQ-5D visual analogue scale (EQ-VAS) and the EQ-5D index. Of 1,479 who completed the EQ-5D, 80% had a PM, 10% an ICD, 5% a CRT-P and 6% a CRT-D. The median age was 77 years with a prevalence of females ranging from 38% in the PM group to 17% in the ICD group. The EQ-VAS and the EQ-5D index significantly increased in patients with PM and CRT-P (EQ-VAS +2.8, standard deviations (SD) 23 and +5.8, SD 24.9; EQ-5D index +0.019, SD 0.114 and +0.051, SD 0.125) while only the EQ-5D index increased in patients with ICD (+0.002, SD 0.104 ). After adjusting for age, sex and HRQoL at baseline, the presence of defibrillator was associated with lower EQ-VAS (-3.4, 95% confidence intervals (CI) -6.7; -0.1 and -4.8, 95% CI -8.8;-0.7) and EQ-5D index (-0.018, 95% CI -0.035; -0.0003 and -0.025 95% CI 0.046;0.004) at follow-up compared to PM. Conclusion These findings, showing the HRQoL associated with CIED, are important to support physicians' and pacemaker nurses' care after device implantation by embracing the patients’ perspectives.