Quality of life in patients with heart failure and implantable cardioverter defibrillators: results from 9274 patients in 42 outpatient heart failure clinics in the National Norwegian Heart Failure Registry

AIMS: Patients with heart failure (HF) have increased risk of sudden cardiac death, and treatment with an implantable cardioverter defibrillator (ICD) has become standard treatment for selected patient groups. HF is associated with impaired quality of life (QoL), but studies on QoL in patients with HF and ICD attending follow-up in outpatient HF clinics is sparse. Hence, this study aimed to determine QoL over time in patients with HF with and without ICD using data from the first visit (baseline) and follow-up visit in 42 outpatient HF clinics. METHODS AND RESULTS: Longitudinal real-world data from the National Norwegian Heart Failure Registry including 9274 patients, of which 1206 with ICD, were studied. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire. Patients with ICD were younger, more often men, and had a higher frequency of coronary artery disease (all P < 0.001). At the first visit, no significant difference in QoL was found between patients with HF with and without ICD, and both groups had significant improvement in QoL from the first to the follow-up visit (P < 0.001). However, patients with HF and ICD reported significantly less improvement (P < 0.001). CONCLUSION: QoL in patients with ICD improves after follow-up in an outpatient HF clinic, although not to the same extent as in patients without ICD. Thus, tailored interventions through a combined HF-ICD care programme are needed to improve QoL in this subgroup of patients with both HF and ICD.