Key result
Most patients (90%) felt their decision for ICD implantation was right, with no significant differences in satisfaction or quality of life between primary and secondary prevention groups.
Why the study?
The psychological impact of ICDs results in severe physical and psychosocial impairment, motivating an analysis of patients' perceptions on decision making, satisfaction, security, and end of life, and differences between primary and secondary prevention.
Are there differences in patient perceptions, satisfaction, quality of life, and end-of-life decisions between primary and secondary prevention ICD recipients?
Cross-Sectional (n=423)
No
Are there differences in patient perceptions, satisfaction, quality of life, and end-of-life decisions between primary and secondary prevention ICD recipients?
ICD recipients generally report high satisfaction and sense of security regardless of primary or secondary prevention indication, though experiencing shocks negatively impacts quality of life and perceived safety.
High satisfaction after ICD decisions appears common; leaves open validation in prospective cohorts before guiding shared decision-making.
Aims: The psychological impact of ICDs results in severe physical and psychosocial impairment. This study attempts to analyze patients’ perceptions on decision making, satisfaction, security and end of life (EOL) as well as explore the similarities and differences between primary and secondary prophylaxis groups. Methods and Results: ICD recipients were asked to complete a questionnaire during routine follow-up (FU) visits, their quality of life (QoL) was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and with the Hospital Anxiety and Depression Scale (HADS). Out of 423 patients (41%CRT-ICD), 349(83%) were recipients with primary prevention indication. The median age was 69 years. Seventy-one (17%) patients reported a shock during a mean FU of 64±44 months. While most patients (90%) felt that their decision was right, younger patients (<69 years) were doubtful. Though no major differences between the two groups were observed, those in secondary prevention group were more in favor of ICDs. With an overall moderate to poor quality of life and mild psychiatric symptoms (Mean QoL-score 29.4±20.3, mean HADS-Score 8.7±7.3), there were no significant differences between both groups. Although 361 (87.4%) patients felt secure and safe, those with shocks were significantly more insecure. Only a minority of patients (31%), mostly younger, considered ICD-deactivation during EOL with no notable difference between the groups. Conclusion: Most patients felt safer following ICD implantation judging their decision for ICD as right. Only a minority considered ICD-deactivation at end of life situations. There were no significant differences between primary and secondary prevention groups.
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Swaroop Varghese (2021) conducted a cross-sectional in Implantable Cardioverter Defibrillators (ICDs) (n=423). Primary prevention ICD indication vs. Secondary prevention ICD indication was evaluated on Proportion of patients regarding their decision for ICD implantation as right (p=0.85). Most patients (90%) felt their decision for ICD implantation was right, with no significant differences in satisfaction or quality of life between primary and secondary prevention groups.
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