What is the clinical evidence from this study?

Study design: Cohort. Population: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) (n=86). Intervention: Implantable cardioverter defibrillators (ICDs). Primary outcome: Psychosocial adjustment, device acceptance, and anxiety.

January 12, 2012Circulation Cardiovascular GeneticsOpen Access

General and Disease-Specific Psychosocial Adjustment in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy With Implantable Cardioverter Defibrillators: A Large Cohort Study

Q: What question did this study set out to answer?

To evaluate general and disease-specific psychosocial adjustment and identify risk factors for poor adjustment in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) living with implantable cardioverter defibrillators (ICDs).

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Key result

Patients with ARVD/C and ICDs exhibited elevated ICD-specific anxiety (mean score 22.9), which was predicted by younger age (P<0.0001), poorer functional capacity, and ICD shocks (P=0.003).

Key Points

To evaluate general and disease-specific psychosocial adjustment and identify risk factors for poor adjustment in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) living with implantable cardioverter defibrillators (ICDs).
Cohort study of N=86 adults (38 male; mean age 45.4±12.9 years) enrolled in the Johns Hopkins ARVD Registry with an ICD in place for a median of 3.2 years (range, 0.2 to 20.1 years).
Assessed ICD-specific anxiety (Florida Shock Anxiety Scale), device acceptance (Florida Patient Acceptance Survey), anxiety and depression (Hospital Anxiety and Depression Scale), and functional capacity (Duke Activity Status Index).
Patients demonstrated elevated body image concerns (mean 17.9±23.5) and device-related distress (mean 26.5±19.2), particularly among younger individuals (P<0.01), despite normal overall device acceptance (mean 76.7±15.3).
Device-specific anxiety (mean 22.9±7.8) was significantly predicted by younger age (P<0.0001), poorer functional capacity (P=0.016), prior ICD shock (P=0.003), and shorter time since implantation (P=0.007).
Poor device adjustment was strongly associated with an increased likelihood of clinically significant general anxiety (P=0.006) and depression (P=0.008).

Study Design

Type

Cohort (n=86)

Multicenter

Structured PICO

Population

86 adults with Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) and an implantable cardioverter defibrillator (ICD) enrolled in the Johns Hopkins ARVD Registry, mean age 45.4±12.9 years, 38 male.

Intervention

Implantable cardioverter defibrillator (ICD) therapy (observational assessment of psychosocial adjustment)

Outcome

Psychosocial adjustment and device acceptance measured by Florida Shock Anxiety Scale, Florida Patient Acceptance Survey, Hospital Anxiety and Depression Scale, and Duke Activity Status Indexpatient reported

Patients with ARVD/C and ICDs, particularly younger patients and those with recent implants or prior shocks, are at elevated risk for device-specific anxiety and poor psychosocial adjustment.

Discussion

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Implication

Younger ARVD/C patients with ICDs may warrant anxiety screening; leaves open need for prospective intervention trials.

Cite This Study

James et al. (2012) conducted a cohort in Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) (n=86). Implantable cardioverter defibrillators (ICDs) was evaluated on Psychosocial adjustment, device acceptance, and anxiety. Patients with ARVD/C and ICDs exhibited elevated ICD-specific anxiety (mean score 22.9), which was predicted by younger age (P<0.0001), poorer functional capacity, and ICD shocks (P=0.003).

synapsesocial.com/papers/6a178b8b5fdf2a7b88aa1f36 https://doi.org/10.1161/circgenetics.111.960898

Topics

Cardiac device therapy

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General and Disease-Specific Psychosocial Adjustment in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy With Implantable Cardioverter Defibrillators: A Large Cohort Study

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

General and Disease-Specific Psychosocial Adjustment in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy With Implantable Cardioverter Defibrillators: A Large Cohort Study

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider