Implantable cardioverter defibrillators: physical and psychosocial outcomes

BACKGROUND: The long-term outcomes of living with an implantable cardioverter defibrillator are an important consideration in recovery. However, little is known about physical and psychosocial outcomes beyond 1 year after implantation. OBJECTIVE: To describe the long-term physical and psychosocial adaptation of persons who have had an implantable cardioverter defibrillator for approximately 2 years or more. METHODS: This nonexperimental cross-sectional study used telephone interviews to ascertain the responses of 80 recipients of implantable cardioverter defibrillators to physical and psychosocial questionnaires to explore the long-term outcomes of living with the devices. Subjects eligible for inclusion were selected from the files of an arrhythmia clinic. RESULTS: Hierarchical regression analysis showed that subjects who are not emotional are likely to be more physically active, especially if they are young and male, and that subjects who tend to be emotional are likely to be psychologically distressed and have poorer social and domestic adaptation. Furthermore, use of emotions was a positive predictor of psychological distress and poor social and domestic adaptation. Subjects reported the use of both emotion- and problem-focused coping. Subjects' scores on physical and psychosocial functioning were comparable to scores reported in the literature for patients who have had myocardial infarction or dysrhythmia. CONCLUSIONS: Emotional responses to distress were predictive of little physical activity and psychological distress. Furthermore, young recipients of implantable cardioverter defibrillators and men were predicted to be physically active. Persons who have had an implantable cardioverter defibrillator for approximately 2 years or more can anticipate that their physical and psychosocial functioning will be similar to that of patients who have myocardial infarction or dysrhythmia.

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