Among patients with ventricular arrhythmias, elevated symptoms of anxiety (53%) and depression (20%) were common and were not predicted by arrhythmia burden.
Observational (n=66)
What is the burden of psychological distress and specific patient concerns among patients with ventricular arrhythmias evaluated in a multidisciplinary clinic?
Patients with ventricular arrhythmias experience high rates of anxiety and depression that are not predicted by arrhythmia burden, highlighting the value of routine PROMs to identify specific concerns like resuming physical activity.
Background Ventricular arrhythmias (VAs) and their treatment have been associated with psychological distress and diminished quality of life (QOL). We administered a battery of patient-reported outcome measures (PROMs) to patients seeing an electrophysiologist and psychologist in a multidisciplinary VA clinic for patients referred for consideration of catheter ablation for sustained VAs or implantable cardioverter-defibrillator therapies. Methods and Results In this retrospective study of the initial VA clinic visit, we analyzed PROMs of: anxiety and depression symptoms, visual analog scales for physical health status and quality of life, cardiac anxiety, implantable cardioverter-defibrillator acceptance, and implantable cardioverter-defibrillator shock anxiety. We quantitated baseline PROM score means and performed correlation analysis with clinical makers of cardiac and VA disease severity. We also performed an item-level analysis of each PROM question to quantify most frequent patient concerns. A total of 66 patients (56±15 years; 77% men) were included; 70% had prior implantable cardioverter-defibrillator shock, and 44% with prior VA ablation. Elevated symptoms of anxiety (53%) and depression (20%) were common. Younger patients had greater symptom burden of general health anxiety, cardiac anxiety, and shock anxiety, and lower device acceptance, but indices of VA burden such as number of ICD shocks and time since last ICD shock did not predict anxiety or depression. Item-level review of cardiac-specific PROMs revealed that >40% of patients expressed concern regarding resumption of physical activity, sex and employment. Conclusions Clinicians can expect elevated symptoms of depression, and cardiac and device-related anxiety among patients with VAs. Routine use of PROMs may elicit these symptoms, which were otherwise not predicted by arrhythmia burden. Review of individual PROM items can facilitate targeting specific patient concerns, which commonly involved physical activity.
Sandhu et al. (Fri,) conducted a observational in Ventricular arrhythmias (n=66). Ventricular arrhythmias and ICD/ablation therapies was evaluated on Patient-reported outcome measures (PROMs) of anxiety, depression, and cardiac-specific concerns. Among patients with ventricular arrhythmias, elevated symptoms of anxiety (53%) and depression (20%) were common and were not predicted by arrhythmia burden.