Why the study?
Does empiric ICD implantation reduce quality of life in patients undergoing CABG surgery with reduced ejection fraction and abnormal signal-averaged ECG?
Does empiric ICD implantation reduce quality of life in patients undergoing CABG surgery with reduced ejection fraction and abnormal signal-averaged ECG?
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Empiric ICD implantation at the time of CABG surgery in high-risk patients is associated with reduced psychological well-being at 6 months, particularly if the device delivers therapy.
UNLABELLED: ICDs can affect a patient's perceived quality-of-life (QOL). This article describes the QOL in patients who participated in The CABG Patch Trial. This trial evaluated the potential benefit of empiric ICD implantation in patients with an increased risk of arrhythmic cardiac death as determined by reduced ejection fraction (<0.36) and an abnormal signal-averaged ECG. Patients were randomized to control (no ICD) or treatment (ICD) limbs. QOL was measured using the SF-36 and other measures among 490 (68%) of 719 patients available at 6-month follow-up. Analysis was performed on 228 control patients (those without ICDs) and 262 patients with ICDs. RESULTS: Six months after having CABG surgery, patients in the ICD group had lower levels of psychological well-being than those in the control group. In addition, compared to controls, patients whose ICDs had delivered therapy reported feeling less healthy, had reduced physical and emotional role functioning, and had lower levels of psychological well-being. CONCLUSION: Strategies aimed at easing patients' adjustment to ICDs should be developed and tested for efficacy in the setting of ICD prophylaxis.
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Namerow et al. (1999) studied this question.
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