Quality of life of patients with cardiac pacemaker: levels, associated characteristics, and the impact of anxiety and depression

Introduction: Implantation of a permanent cardiac pacemaker (PPM) improves recipients’ quality of life (QoL). However, psychiatric disturbance may adversely affect QoL and undermine clinical outcomes.  Aim: To explore impact of anxiety and depression on QoL of PPM recipients.  Materials and methods: A hundred and fifty PPM recipients were enrolled. Data collection was performed by completing the Hospital Anxiety and Depression Scale (HADS) and the SF-36 Health Survey (SF-36). Demographic characteristics were also included. The statistical significance level was p <0.05. Results: Almost a quarter of the patients experienced anxiety (25.3%) and depression (26.0%). In terms of QoL, patients showed moderate to high levels in social functionality, energy/fatigue, emotional well-being and pain (median: 50, 60, 72, and 67.5, respectively) and poor levels in physical functioning, physical role and emotional role (medians: 22, 0, and 0 respectively). In addition, patients had moderate levels of general health (median 48.5). All QoL subscales were negatively associated with anxiety and depression of patients on a univariate level ( p <0.05). Regarding demographic variables affecting QoL, age was statistically significantly associated with physical role ( p =0.025), emotional role ( p =0.005), social functioning ( p =0.033), and pain ( p =0.018). Furthermore, physical role was statistically significantly associated with number of children ( p =0.024), emotional role with education level ( p =0.011), social functioning with family status ( p =0.018), and general health with residency ( p =0.006).  Conclusions: Demographic characteristics and anxiety/depression are related with QoL. A better understanding of these associations may help clinicians in planning rational and cost-effective interventions.