Posttraumatic stress and anxiety in patients with an implantable cardioverter defibrillator: Trajectories and vulnerability factors

BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy is the first-line treatment for the primary and secondary prevention of sudden cardiac death. Despite the unequivocal medical benefits, living with an ICD may affect patients' psychological functioning and general well-being. We examined the trajectories of symptoms of posttraumatic stress disorder (PTSD) and anxiety in patients with an ICD and the vulnerability factors associated with an increased risk of symptoms of PTSD and anxiety. METHODS: A total of 249 patients were included as part of the WEB-based distress program for implantable CARdioverter dEfibrillator patients (WEBCARE) study. Data were analyzed using Latent class analyses, with trajectories of PTSD symptomatology and anxiety examined between baseline and 12 months follow-up. RESULTS: The mean age of the sample was 58.9 ± 9.8, with the majority being male (82%). Latent Class analyses (LatentGOLD) revealed four classes with respect to PTSD symptomatology, and three classes of patients with respect to anxiety. Younger age, increased depression score at baseline, and Type D personality were all associated with increased vulnerability for posttraumatic stress and anxiety symptoms. CONCLUSION: Comparable trajectories were found for symptoms of PTSD and anxiety over time. Patients with a younger age, increased depression score at baseline, and Type D personality were especially prone to experience PTSD and anxiety symptomatology at 12 months follow-up. Due to the negative association between PTSD, anxiety, and health outcomes, it is paramount to timely identify the subset of patients who are vulnerable to experience these symptoms and provide them with personalized support.