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Psychiatric Aspects of Sudden Cardiac Arrest and Implantable Cardioverter-Defibrillators

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Brain and Heart Dynamics

Abstract

People affected by diseases linked to an increased risk of sudden death, including cardiomyopathies and cardiac “channellopatiens,” can benefit from the implantation of an ICD (implantable cardioverter-defibrillator). Penetrance and phenotypic expression of such diseases are very variable, which leads to an increase of psychological distress among these patients. For instance, an increased prevalence of mood disorders, anxiety disorders, and substance abuse disorders is found in people affected by hypertrophic cardiomyopathy. Moreover, symptomatic long QT syndrome (LQTS) patients are generally more depressed than asymptomatic ones, taking into account that depression and arrhythmic events are strongly interrelated and that most antidepressants are known to prolong the QT interval. Also the Brugada syndrome, another potentially lethal familiar cardiac disease, is known to be possibly triggered or worsened by the use of antidepressants and mood stabilizers. Patients affected by catecholaminergic polymorphic ventricular tachycardia (CPVT) have a higher rate of anxiety, depression, and post-traumatic stress symptoms compared to the general population. In addition, the implantation of the ICD in itself proved to be a very stressful event for the patients, who worry about many factors: first of all, they are afraid of having to experience the shocks delivered by the device, but also of potentially losing their independence. ICD implants may also have a bad impact on body image perception and lead to the feeling of being “impaired” and useless. ICDs have in fact been linked to many psychiatric comorbidities like anxiety and depression, but also post-traumatic stress disorder and adjustment disorders.

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Author information

Authors and Affiliations

  1. Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Simone Savastano

  2. Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Simone Savastano

  3. Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy

    Enrico Baldi

  4. Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Enrico Baldi

  5. Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Enrico Baldi

  6. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

    Natascia Brondino

Authors
  1. Simone Savastano
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  2. Enrico Baldi
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  3. Natascia Brondino
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Correspondence to Simone Savastano .

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Editors and Affiliations

  1. Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy

    Stefano Govoni

  2. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

    Pierluigi Politi

  3. Department of Molecular Medicine, University of Pavia, Pavia, Italy

    Emilio Vanoli

Section Editor information

  1. Dipartiment of Brain and Behavioral Science, University of Pavia, Pavia, Italy

    Matteo Rocchetti

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Savastano, S., Baldi, E., Brondino, N. (2020). Psychiatric Aspects of Sudden Cardiac Arrest and Implantable Cardioverter-Defibrillators. In: Govoni, S., Politi, P., Vanoli, E. (eds) Brain and Heart Dynamics. Springer, Cham. https://doi.org/10.1007/978-3-030-28008-6_21

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  • DOI: https://doi.org/10.1007/978-3-030-28008-6_21

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