Phone-Delivered Mindfulness Training for Patients with Implantable Cardioverter Defibrillators: Results of a Pilot Randomized Controlled Trial
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The reduction in adrenergic activity and anxiety associated with meditation may be beneficial for patients with implantable cardioverter defibrillators.
This study aims to determine the feasibility of a phone-delivered mindfulness intervention in patients with defibrillators and to obtain preliminary indications of efficacy on mindfulness and anxiety.
Clinically stable outpatients were randomized to a mindfulness intervention (eight weekly individual phone sessions) or to a scripted follow-up phone call. We used the Hospital Anxiety and Depression Scale and the Five Facets of Mindfulness to measure anxiety and mindfulness, and multivariate linear regression to estimate the intervention effect on pre-post-intervention changes in these variables.
We enrolled 45 patients (23 mindfulness and 22 control; age, 43–83; 30 % women). Retention was 93 %; attendance was 94 %. Mindfulness (beta = 3.31; p = 0.04) and anxiety (beta = −1.15; p = 0.059) improved in the mindfulness group.
Mindfulness training can be effectively phone-delivered and may improve mindfulness and anxiety in cardiac defibrillator outpatients.
- Moss AJ, Hall WJ, Cannom DS, et al. The Multicenter Automatic Defibrillator Implantation Trial Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996;335:1933-1940. CrossRef
- The Antiarrhythmics Versus Implantable Defibrillators Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med. 1997;337:1576-1584. CrossRef
- Moss AJ, Greenberg H, Case RB, et al. Long-term clinical course of patients after termination of ventricular tachyarrhythmia by an implanted defibrillator. Circulation. 2004;110:3760-3765. CrossRef
- Bardy GH, Lee KL, Mark DB, et al. Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352:225-237. CrossRef
- Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877-883. CrossRef
- Kamphuis HCM, de Leeuw JRJ, Derksen R, Hauer RNW, Winnubst JAM. Implantable cardioverter defibrillator recipients: Quality of life in recipients with and without ICD shock delivery: A prospective study. Europace. 2003;5:381-389. CrossRef
- Schron EB, Exner DV, Yao Q, et al. Quality of life in the Antiarrhythmics Versus Implantable Defibrillators Trial: Impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation. 2002;105:589-594. CrossRef
- Namerow P, Firth B, Heywood G, Windle J, Parides M. Quality-of-life six months after CABG surgery in patients randomized to ICD versus no ICD therapy: Findings form CABG PATCH trial. Pacing Clin Electrophysiol. 1999;22:1305-1313. CrossRef
- Pedersen SS, van Domburg RT, Theuns DA, Jordaens L, Erdman RA. Concerns about the implantable cardioverter defibrillator: A determinant of anxiety and depressive symptoms independent of experienced shocks. Am Heart J. 2005;149:664-669. CrossRef
- Ladwig K-H, Baumert J, Marten-Mittag B, Kolb C, Zrenner B, Schmitt C. 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;65:1324-1330. CrossRef
- Bostwick JM, Christopher LS. An updated review of implantable cardioverter/defibrillators, induced anxiety, and quality of life. Psychiatr Clin North Am. 2007;30:677-688. CrossRef
- Magyar-Russell G, Thombs BD, Cai JX, et al. The prevalence of anxiety and depression in adults with implantable cardioverter defibrillators: A systematic review. J Psychosom Res. 2011;71:223-231. CrossRef
- Kawachi I, Sparrow D, Vokonas PS, Weiss ST. Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study. Circulation. 1994;90:2225-2229. CrossRef
- Nabi H, Hall M, Koskenvuo M, et al. Psychological and somatic symptoms of anxiety and risk of coronary heart disease: The Health and Social Support prospective cohort study. Biol Psychiatry. 2009;67:378-385. CrossRef
- Sears SF, Vazquez LD, Matchett M, Pitzalis M. State-of-the-art: Anxiety management in patients with implantable cardioverter defibrillators. Stress Heal. 2008;24:239-248. 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;73:226-233. 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;72:434-441. CrossRef
- Salmoirago-Blotcher E, Ockene IS. Methodological limitations of psychosocial interventions in patients with an implantable cardioverter-defibrillator (ICD): A systematic review. BMC Cardiovasc Disord. 2009;9:56. CrossRef
- Benson H. The relaxation response: Its subjective and objective historical precedents and physiology. Trends Neurosci. 1983;6:281-284. CrossRef
- Benson H, Alexander S, Feldman C. Decreased premature ventricular contractions through use of the relaxation response in patients with stable ischaemic heart-disease. Lancet. 1975;2:380-382. CrossRef
- Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33-47. CrossRef
- Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis. J Psychosom Res. 2010;68:539-544. CrossRef
- Sullivan MJ, Wood L, Terry J, et al. The Support, Education, and Research in Chronic Heart Failure Study (SEARCH): A mindfulness-based psychoeducational intervention improves depression and clinical symptoms in patients with chronic heart failure. Am Heart J. 2009;157:84-90. CrossRef
- Vijgen J, Botto G, Camm J, et al. Consensus statement of the European Heart Rhythm Association: Updated recommendations for driving by patients with implantable cardioverter defibrillators. Europace. 2009;11:1097-1107. CrossRef
- Salmoirago-Blotcher E, Carmody J, Yeh G, Crawford S, Rosenthal L, Ockene I. Design and methods for a pilot study of a phone-delivered, mindfulness-based intervention in patients with implantable cardioverter defibrillators. Evid Based Complement Alternat Med. 2012;2012:972106. CrossRef
- Katzman R, Brown T, Fuld P, Peck A, Schechter R, Schimmel H. Validation of a short Orientation-Memory-Concentration Test of cognitive impairment. Am J Psychiatry. 1983;140:734-739.
- StataCorp. Stata Statistical Software, version 10. College Station, TX: StataCorp, LP, 2007.
- Bellg AJ, Borrelli B, Resnick B, et al. Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004;23:443-451. CrossRef
- Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13:27-45. CrossRef
- Zigmond A, Snaith R. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361-370. CrossRef
- Ingvar B, Alv AD, Tone Tangen H, Dag N. The validity of the Hospital Anxiety and Depression Scale: An updated literature review. J Psychosom Res. 2002;52:69-77. CrossRef
- Spertus JA, Winder JA, Dewhurst TA, et al. Development and evaluation of the Seattle Angina questionnaire: A new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995;25:333-341. CrossRef
- Assmann SF, Pocock SJ, Enos LE, Kasten LE. Subgroup analysis and other (mis)uses of baseline data in clinical trials. Lancet. 2000;355:1064-1069. CrossRef
- Pocock SJ, Assmann SE, Enos LE, Kasten LE. Subgroup analysis, covariate adjustment and baseline comparisons in clinical trial reporting: Current practice and problems. Stat Med. 2002;21:2917-2930. CrossRef
- Chuang-Stein C, Tong DM. The impact and implication of regression to the mean on the design and analysis of medical investigations. Stat Methods Med Res. 1997;6:115-128. CrossRef
- Mace C. Mindfulness in psychotherapy: An introduction. Adv Psychiatr Treat. 2007;13:147-154. CrossRef
- Fitchet A, Doherty PJ, Bundy C, Bell W, Fitzpatrick AP, Garratt CJ. Comprehensive cardiac rehabilitation programme for implantable cardioverter-defibrillator patients: A randomised controlled trial. Heart. 2003;89:155-160. CrossRef
- Frizelle DJ, Lewin RJP, Kaye G, et al. Cognitive-behavioural rehabilitation programme for patients with an implanted cardioverter defibrillator: A pilot study. Br J Health Psychol. 2004;9:381-392. CrossRef
- Mohr DC, Vella L, Hart S, Heckman T, Simon G. The effect of telephone-administered psychotherapy on symptoms of depression and attrition: A meta-analysis. Clin Psychol. 2008;15:243-253.
- Yeh GY, McCarthy EP, Wayne PM, et al. Tai chi exercise in patients with chronic heart failure: A randomized clinical trial. Arch Intern Med. 2011;171:750-757. CrossRef
- Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med. 2008;31:23-33. CrossRef
- Nyklicek I, Kuijpers KF. Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: Is increased mindfulness indeed the mechanism? Ann Behav Med. 2008;35:331-340. CrossRef
- Grossman P. On measuring mindfulness in psychosomatic and psychological research. J Psychosom Res. 2008;64:405-408. CrossRef
- Christopher M, Christopher V, Charoensuk S. Assessing Western mindfulness among Thai Theravada Buddhist monks. Ment Health Relig Cult. 2009;12:303-314. CrossRef
- Phone-Delivered Mindfulness Training for Patients with Implantable Cardioverter Defibrillators: Results of a Pilot Randomized Controlled Trial
Annals of Behavioral Medicine
Volume 46, Issue 2 , pp 243-250
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Implantable cardioverter defibrillators
- Industry Sectors
- Author Affiliations
- 1. Division of Cardiovascular Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, room S3-855, Worcester, MA, USA
- 2. Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- 3. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA