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The influence of age on the psychological profile of patients with cardiac implantable electronic devices: results from the Italian population in a multicenter study conducted by the European Heart Rhythm Association

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Abstract

Background

Cardiac implantable electronic devices (CIEDs) are widely used to treat bradyarrhythmias or improve the prognosis of patients with heart failure (HF).

Aims

To evaluate age-related (≤ 75 vs. > 75 years) attitudes, worries, psychological effects and needs in an Italian CIEDs population.

Methods

Patients attending their periodical ambulatory evaluation received a questionnaire conceived by the European Heart Rhythm Association Scientific Initiatives Committee as part of a multicenter, multinational snapshot survey. Seven countries participated in the study, and 1646 replies were collected. Of these, 437 (27%) were from Italy. Present results refer to the Italian population only. CIEDs were stratified into devices to treat bradycardia or HF.

Results

The use of CIEDs was more common in advanced age. Older patients needed less information about CIEDs than younger ones (p = 0.044), who would prefer to be better informed about CIEDs-related consequences on psychologic profile (p = 0.045), physical (p < 0.001) and sexual (p < 0.001) activities, and driving limitations (p = 0.003). When compared to older subjects, younger individuals experienced more difficulties (p = 0.035), especially in their professional (p < 0.001) and private life (p = 0.033), feeling their existence was limited by the device (p < 0.001). Conversely, quality of life (HRQL) more often improved in the elderly (p = 0.001). Information about what to do with CIEDs at the end of life is scant independently of age.

Conclusions

HRQL after CIEDs implantation improves more frequently in older patients, while the psychological burden of CIEDs is usually higher in younger patients. End of life issues are seldom discussed.

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Acknowledgements

We would like to thank the EHRA Electrophysiology Research Network Centers, which allowed to reach a relevant number of patients participating to the survey. Thanks to Enrico Antonini, DLit, Mrs. Angela Dichiara and Mrs. Patrizia Mirone, for their support in the conduction of the study.

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Authors and Affiliations

  1. Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit, University of Florence and AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy

    Stefano Fumagalli, Anna T. Roberts & Niccolò Marchionni

  2. Electrophysiology Laboratory, University of Florence and AOU Careggi, Florence, Italy

    Paolo Pieragnoli & Giuseppe Ricciardi

  3. Oslo University Hospital, Oslo, Norway

    Kristina H. Haugaa

  4. University of Belgrade, Belgrade, Serbia

    Tatjana S. Potpara

  5. Department of Health Sciences, Department of Health Professions, University of Florence and AOU Careggi, Florence, Italy

    Laura Rasero & Giulia Zuo

  6. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Nicola Ramacciati

  7. Montevergine Cardiology Clinic, Mercogliano, Italy

    Francesco Solimene & Giuseppe Mascia

  8. Clinical Institute Humanitas Gavazzeni, Bergamo, Italy

    Giosuè Mascioli

  9. Silesian Center for Heart Diseases, Zabrze, Poland

    Radoslaw Lenarczyk

  10. Cardiology Department, Clinique Pasteur, Toulouse, France

    Serge Boveda

  11. Department of Electrophysiology, Heart Center of Leipzig, Leipzig, Germany

    Nikolaos Dagres

Authors
  1. Stefano Fumagalli
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  2. Paolo Pieragnoli
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  3. Kristina H. Haugaa
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  4. Tatjana S. Potpara
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  5. Laura Rasero
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  7. Giuseppe Ricciardi
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  8. Francesco Solimene
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  9. Giuseppe Mascia
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  10. Giosuè Mascioli
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  11. Giulia Zuo
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  12. Anna T. Roberts
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  13. Niccolò Marchionni
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  14. Radoslaw Lenarczyk
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  15. Serge Boveda
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  16. Nikolaos Dagres
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Corresponding author

Correspondence to Stefano Fumagalli.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the Helsinki declaration.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Fumagalli, S., Pieragnoli, P., Haugaa, K.H. et al. The influence of age on the psychological profile of patients with cardiac implantable electronic devices: results from the Italian population in a multicenter study conducted by the European Heart Rhythm Association. Aging Clin Exp Res 31, 1219–1226 (2019). https://doi.org/10.1007/s40520-018-1088-5

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  • DOI: https://doi.org/10.1007/s40520-018-1088-5

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