Patients experiencing two or more annual ICD discharges had a significantly higher incidence of panic disorders and agoraphobia compared to those with a single annual discharge (62% vs 10%, p<0.01).
Observational (n=90)
Do ICD discharges increase the risk of panic disorders and agoraphobia in patients with ICDs?
ICD discharges, particularly multiple annual shocks, are significantly associated with the development of panic disorders and agoraphobia, highlighting the need for psychological support and minimizing unnecessary shocks.
Absolute Event Rate: 62% vs 10%
p-value: p=<0.01
BACKGROUND: Implantable cardioverter/defibrillator (ICD) treatment has reduced the mortality of patients with a high risk of sudden cardiac death. However, ICD discharges may cause anxiety with respect to new discharges and lead to preventive, for example, phobic, behavior. This study evaluated the frequency of panic disorders and agoraphobia in patients with ICD and assessed the risk factors in their development. HYPOTHESIS: Treatment with ICD represents a risk factor in the development of anxiety disorders. METHODS: Ninety patients with ICD were examined using a standardized lifetime Diagnostic Interview of Psychiatric Syndromes (DIPS). This interview makes it possible to estimate the incidence of panic disorders and agoraphobia. The impact of the severity of the underlying cardiac disease, the number of ICD discharges, and the subjective appraisal of the shock experience on the development of panic disorders and agoraphobia was assessed. RESULTS: Fifteen patients (16.7%) developed anxiety disorders after ICD implantation. The incidence was 21% in patients with and 6.9% in patients without ICD discharge. In patients with two or more ICD discharges annually, the incidence of panic disorders and agoraphobia was higher than that in patients with a single ICD discharge annually (62 vs. 10%, p<0.01). The intensity of self-observation of their body was significantly related to the development of anxiety disorders (p<0.001). CONCLUSION: Panic disorders and agoraphobia are frequent side effects of ICD treatment. Risk factors in the development of these disorders are two or more ICD discharges annually and a negative cognitive appraisal of ICD discharges. Therapeutic efforts should aim at reducing the number of ICD discharges and provide early psychological treatment.
Godemann et al. (Tue,) conducted a observational in Implantable cardioverter/defibrillator (ICD) recipients (n=90). Two or more annual ICD discharges vs. Single annual ICD discharge was evaluated on Incidence of panic disorders and agoraphobia (p=<0.01). Patients experiencing two or more annual ICD discharges had a significantly higher incidence of panic disorders and agoraphobia compared to those with a single annual discharge (62% vs 10%, p<0.01).