The Quality of Life of Patients With Life-Threatening Arrhythmias

BACKGROUND: The treatment of life-threatening arrhythmias with amiodarone or an implantable cardioverter/defibrillator prolongs patient survival but with significant comorbidity. Previous studies have shown diminished health status and increased psychologic distress and inferred a diminished quality of life; however, a multidimensional analysis of quality of life, including patient perception, has not been performed. METHODS: One hundred four consecutive patients were surveyed regarding patient demographics, health status, psychologic distress, and patient-perceived quality of life. The patients were treated with amiodarone (n = 30) with an implantable cardioverter/defibrillator (n = 45) and the remainder were reference patients (n = 29). RESULTS: This study confirms that patients who survive life-threatening arrhythmias have diminished health status and increased psychologic distress; however, patient-perceived quality of life is preserved. These patients report a better perceived quality of life (as measured by the Quality of Life Index) than the reference group (22.3 +/- 4.0 vs 20.5 +/- 4.4, P < .05) and their scores are similar to those of normal healthy volunteers (mean score, 21.9). The improved quality of life scores were not dependent on treatment modality (22.1 +/- 4.0 vs 22.4 +/- 4.1 for medical vs surgical groups, respectively). CONCLUSIONS: Patient-perceived quality of life is maintained in patients who survive life-threatening arrhythmias despite their diminished health status and increased psychologic distress. Measured quality of life is independent of treatment modality. Thus, caution must be exercised in assuming a diminished quality of life in patients who have survived a life-threatening cardiac event.