Key result
Sudden cardiac arrest survivors receiving an initial ICD reported a greater number of physical symptoms, lower levels of mental health, and lower outcome expectations over 12 months compared to other arrhythmia patients, despite participation in a social cognitive theory intervention.
Why the study?
Sudden cardiac arrest survivorship results in unique issues in physical and psychological recovery, but comparisons with other arrhythmia patients receiving a first-time secondary prevention ICD during a behavioral intervention were needed.
Does a social cognitive theory intervention improve physical function, psychological adjustment, and self-efficacy differently in sudden cardiac arrest survivors compared to other arrhythmia patients receiving a first-time ICD?
RCT (n=168)
Open-label
Random number generator
Yes
Does a social cognitive theory intervention improve physical function, psychological adjustment, and self-efficacy differently in sudden cardiac arrest survivors compared to other arrhythmia patients receiving a first-time ICD?
Sudden cardiac arrest survivors experience more physical symptoms and lower mental health recovery over 12 months post-ICD implantation compared to other arrhythmia patients, highlighting a need for tailored survivorship care.
Answers are grounded in this paper and cite their sources.
SCA survivors need tailored post-ICD support for persistent symptoms and mental health; challenges uniform SCT efficacy across secondary prevention indications.
BACKGROUND: Sudden cardiac arrest (SCA) survivorship results in unique issues in return to physical and psychological function. The purpose of the study was to compare recovery across the first year between SCA survivors and other arrhythmia patients who received a first-time implantable cardioverter defibrillator (ICD) for secondary prevention, participating in a social cognitive theory (SCT) intervention. METHODS: 168 (129 males, 39 females) who received an ICD for secondary prevention (SCA N = 65; other arrhythmia N = 103) were randomized to one of two study conditions: SCT intervention (N = 85) or usual care (N = 83). Outcomes were measured at baseline hospital discharge, 1, 3, 6, & 12 months: (1) Physical Function: Patient Concerns Assessment (PCA), SF-36 (PCS); (2) Psychological Adjustment: State Trait Anxiety (STAI), CES-D depression, SF-36 (MCS); (3) Self-Efficacy: Self-Efficacy (SCA-SE), Self-management Behaviors (SMB), Outcome Expectations (OE). Outcomes were compared over 12 months for intervention condition x ICD indication using general estimating equations. RESULTS: Participants were Caucasian (89%), mean age 63.95 ± 12.3 years, EF% 33.95 ± 13.9, BMI 28.19 ± 6.2, and Charlson Index 4.27 ± 2.3. Physical symptoms (PCA) were higher over time for SCA survivors compared to the other arrhythmia group (p = 0.04), ICD shocks were lower in SCA survivors in the SCT intervention (p = 0.01); psychological adjustment (MCS) was significantly lower in SCA survivors in the SCT intervention over 6 months, which improved at 12 months (p = 0.05); outcome expectations (OE) were significantly lower for SCA survivors in the SCT intervention (p = 0.008). CONCLUSIONS: SCA survivors had greater number of physical symptoms, lower levels of mental health and outcome expectations over 12 months despite participation in a SCT intervention. Trial registration Clinicaltrials.gov: NCT04462887.
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Dougherty et al. (2022) conducted an RCT in Sudden cardiac arrest and other ventricular arrhythmias requiring secondary prevention ICD (n=168). Social cognitive theory (SCT) intervention vs. Usual care was evaluated on Physical symptoms (Patient Concerns Assessment) over 12 months for SCA survivors vs other arrhythmia patients (p=0.04). Sudden cardiac arrest survivors receiving an initial ICD reported a greater number of physical symptoms, lower levels of mental health, and lower outcome expectations over 12 months compared to other arrhythmia patients, despite participation in a social cognitive theory intervention.
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