ICD surgery: highlighting the psychological consequences

An implantable cardioverter defibrillator (ICD) can terminate episodes of ventricular tachycardia or fibrillation, thereby reducing the risk of sudden death in patients with a range of cardiac diseases. It is recommended as both a primary and secondary prevention measure. The survival benefit of ICD surgery is well documented, and it is a cost-effective alternative to optimal pharmacological therapy to prevent sudden cardiac death. Many patients who have had an ICD fitted, however, experience compromised quality of life as well as depression and anxiety after implantation. ICD shocks, whether appropriate or inappropriate, play an important role in the post-surgery experience of ICD recipients, as does personality and social support. Psychological screening of patients who have an ICD fitted is recommended as part of cardiac rehabilitation.