Trajectories of Perceived Emotional and Physical Distress in Patients with an Implantable Cardioverter Defibrillator
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Little is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).
We examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors.
Dutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline.
Latent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not.
The course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.
- Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Writing Committee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 2008;117:e350–408. CrossRef
- Ezekowitz JA, Armstrong PW, McAlister FA. Implantable cardioverter defibrillators in primary and secondary prevention: a systematic review of randomized, controlled trials. Ann Intern Med. 2003;138:445–52. CrossRef
- Pedersen SS, Van den Broek KC, Theuns DA, et al. Risk of chronic anxiety in implantable defibrillator patients: a multi-center study. Int J Cardiol. 2011;147:420–3. CrossRef
- Van den Broek KC, Nyklicek I, Van der Voort PH, et al. Shocks, personality, and anxiety in patients with an implantable defibrillator. Pacing Clin Electrophysiol. 2008;31:850–7. CrossRef
- Thomas SA, Friedmann E, Gottlieb SS, et al. Changes in psychosocial distress in outpatients with heart failure with implantable cardioverter defibrillators. Heart Lung. 2009;38:109–20. CrossRef
- Pedersen SS, Sears SF, Burg MM, et al. Does ICD indication affect quality of life and levels of distress? Pacing Clin Electrophysiol. 2009;32:153–6. CrossRef
- Pedersen SS, van den Berg M, Theuns DA. A viewpoint on the impact of device advisories on patient-centered outcomes. Pacing Clin Electrophysiol. 2009;32:1006–11. CrossRef
- Pedersen SS, van den Broek KC, van den Berg M, et al. Shock as a determinant of poor patient-centered outcomes in implantable cardioverter defibrillator patients: is there more to it than meets the eye? Pacing Clin Electrophysiol. 2010;33:1430–6. CrossRef
- Sears SF, Lewis TS, Kuhl EA, et al. Predictors of quality of life in patients with implantable cardioverter defibrillators. Psychosomatics. 2005;46:451–7. CrossRef
- Pedersen SS, Theuns DA, Muskens-Heemskerk A, et al. Type-D personality but not implantable cardioverter-defibrillator indication is associated with impaired health-related quality of life 3 months post-implantation. Europace. 2007;9:675–80. CrossRef
- Johansen JB, Pedersen SS, Spindler H, et al. Symptomatic heart failure is the most important clinical correlate of impaired quality of life, anxiety, and depression in implantable cardioverter-defibrillator patients: a single-centre, cross-sectional study in 610 patients. Europace. 2008;10:545–51. CrossRef
- Carroll DL, Hamilton GA, Kenney BJ. Changes in health status, psychological distress, and quality of life in implantable cardioverter defibrillator recipients between 6 months and 1 year after implantation. Eur J Cardiovasc Nurs. 2002;1:213–9. CrossRef
- Dougherty CM. Psychological reactions and family adjustment in shock versus no shock groups after implantation of internal cardioverter defibrillator. Heart Lung. 1995;24:281–91. CrossRef
- Kapa S, Rotondi-Trevisan D, Mariano Z, et al. Psychopathology in patients with ICDs over time: results of a prospective study. Pacing Clin Electrophysiol. 2010;33:198–208. CrossRef
- Carroll DL, Hamilton GA. Long-term effects of implanted cardioverter-defibrillators on health status, quality of life, and psychological state. Am J Crit Care. 2008;17:222–30. quiz 31.
- Crossmann A, Pauli P, Dengler W, et al. Stability and cause of anxiety in patients with an implantable cardioverter-defibrillator: a longitudinal two-year follow-up. Heart Lung. 2007;36:87–95. CrossRef
- Kamphuis HC, De Leeuw JR, Derksen R, et al. A 12-month quality of life assessment of cardiac arrest survivors treated with or without an implantable cardioverter defibrillator. Europace. 2002;4:417–25. CrossRef
- Pedersen SS, Theuns DA, Jordaens L, et al. Course of anxiety and device-related concerns in implantable cardioverter defibrillator patients the first year post implantation. Europace. 2010;12:1119–26. CrossRef
- van den Broek KC, Nyklicek I, van der Voort PH, et al. Risk of ventricular arrhythmia after implantable defibrillator treatment in anxious type D patients. J Am Coll Cardiol. 2009;54:531–7. CrossRef
- Pedersen SS, van den Broek KC, Erdman RA, et al. Pre-implantation implantable cardioverter defibrillator concerns and Type D personality increase the risk of mortality in patients with an implantable cardioverter defibrillator. Europace. 2010;12:1446–52. CrossRef
- Piotrowicz K, Noyes K, Lyness JM, et al. Physical functioning and mental well-being in association with health outcome in patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial II. Eur Heart J. 2007;28:601–7. CrossRef
- Ladwig KH, Baumert J, Marten-Mittag B, et al. Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study. Arch Gen Psychiatry. 2008;65:1324–30. CrossRef
- Van der Ploeg HM, Defares PB, Spielberger CD. [Handleiding bij de Zelf-Beoordelings Vragenlijst (ZBV). Een nederlandstalige bewerking van de Spielberger State-Trait Anxiety Inventory]. Manual for the ZBV. A Dutch-language adaptation of the Spielberger State-Trait Anxiety Inventory. Lisse: Swets & Zeitlinger B.V.; The Netherlands 1980.
- Beck AT, Steer RA. Manual for the revised Beck Depression Inventory. 1993.
- Denollet J. Health complaints and outcome assessment in coronary heart disease. Psychosom Med. 1994;56:463–74.
- Pedersen SS, Denollet J. Perceived health following myocardial infarction: cross-validation of the Health Complaints Scale in Danish patients. Behav Res Ther. 2002;40:1221–30. CrossRef
- Pedersen SS, Denollet J. Is Type D personality here to stay? Emerging evidence across cardiovascular disease patient groups. Curr Cardiol Rev. 2006;2:205–13. CrossRef
- Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med. 2005;67:89–97. CrossRef
- Emons WH, Meijer RR, Denollet J. Negative affectivity and social inhibition in cardiovascular disease: evaluating type-D personality and its assessment using item response theory. J Psychosom Res. 2007;63:27–39. CrossRef
- Martens EJ, Kupper N, Pedersen SS, et al. Type D personality is a stable taxonomy in post-MI patients over an 18-month period. J Psychosom Res. 2007;63:545–50. CrossRef
- Denollet J. Depression, distressed (Type D) personality, and cardiovascular outcomes. Dialogues in Cardiovascular Medicine 2012, In press.
- Reiss S, Peterson RA, Gursky DM, et al. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther. 1986;24:1–8. CrossRef
- Vermunt JK, Magidson J. Technical guide for Latent GOLD choice 4.0: Basic and advanced. Belmont Massachusetts: Statistical Innovations Inc; 2005.
- Schwarz G. Estimating the dimension of a model. Ann Stat. 1978;6:461–4. CrossRef
- Irvine J, Dorian P, Baker B, et al. Quality of life in the Canadian Implantable Defibrillator Study (CIDS). Am Heart J. 2002;144:282–9. CrossRef
- Pedersen SS, van den Broek KC, Sears Jr SF. Psychological intervention following implantation of an implantable defibrillator: a review and future recommendations. Pacing Clin Electrophysiol. 2007;30:1546–54. CrossRef
- Irvine J, Firestone J, Ong L, et al. A randomized controlled trial of cognitive behavior therapy tailored to psychological adaptation to an implantable cardioverter defibrillator. Psychosom Med. 2011;73:226–33. CrossRef
- Crossmann A, Schulz SM, Kuhlkamp V, et al. A randomized controlled trial of secondary prevention of anxiety and distress in a German sample of patients with an implantable cardioverter defibrillator. Psychosom Med. 2010;72:434–41. CrossRef
- Dunbar SB, Langberg JJ, Reilly CM, et al. Effect of a psychoeducational intervention on depression, anxiety, and health resource use in implantable cardioverter defibrillator patients. Pacing Clin Electrophysiol. 2009;32:1259–71. CrossRef
- Pedersen SS, Spek V, Theuns DA, et al. Rationale and design of WEBCARE: a randomized, controlled, web-based behavioral intervention trial in cardioverter-defibrillator patients to reduce anxiety and device concerns and enhance quality of life. Trials. 2009;10:120. CrossRef
- Gulliksson M, Burell G, Vessby B, et al. Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Arch Intern Med. 2011;171:134–40. CrossRef
- Pelle AJM, Van den Broek KC, Denollet J. Interventions aimed at altering Type D personality. In: Dornelas EA, editor. Stress proofing the heart: behavioral approaches for cardiac patients. New York: Springer; 2012.
- Smits JA, Berry AC, Tart CD, et al. The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: a meta-analytic review. Behav Res Ther. 2008;46:1047–54. CrossRef
- Broman-Fulks JJ, Storey KM. Evaluation of a brief aerobic exercise intervention for high anxiety sensitivity. Anxiety Stress Coping. 2008;21:117–28. CrossRef
- Trajectories of Perceived Emotional and Physical Distress in Patients with an Implantable Cardioverter Defibrillator
International Journal of Behavioral Medicine
Volume 21, Issue 1 , pp 149-159
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Implantable cardioverter defibrillator
- Health Status
- Author Affiliations
- 1. Department of Medical Psychology, CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- 2. Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
- 3. Department of Cardiology, Amphia Hospital, Breda, The Netherlands