Heart devices do not impair quality of life

By Will Boggs, MD

NEW YORK (Reuters Health) - Commonly used heart devices called implantable cardioverter defibrillators generally do not worsen a patient's quality of life, according to a report in the Archives of Internal Medicine.

Implantable cardioverter defibrillators, usually referred to as ICDs, sense when the heart is beating too fast or erratically and provide a corrective, potentially life-saving, shock.

The current findings suggest that while ICDs usually have little impact on quality of life, when they generate multiple shocks, the patient may suffer mentally and emotionally.

"As we put ICDs in larger number of patients for (protection against life-threatening heart beat abnormalities) we need to make sure we aren't causing a decrease in the quality of life as we attempt to prolong the duration of life," Dr. Rod Passman told Reuters Health. "This study confirms that, in fact, most patients accept device implantation without difficulty and live their lives in a normal manner."

Passman from Northwestern University Feinberg School of Medicine, Chicago, and associates assessed the impact of ICD implantation and shocks on the quality of life of patients in the Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (DEFINITE) study. A variety of standard questionnaires were used to assess quality of life.

There were no detectable differences in quality of life between patients treated with ICDs and those given standard medical therapy during the 36-month study, the authors report. However, patients who had received multiple shocks from the device did show impairments in emotional and mental quality of life.

"Both physicians and patients need to know that the receipt of multiple shocks may impact quality of life," Passman said. "The physician can do two important things; program the device and treat other (fast heart beats) in a manner that would reduce the number of inappropriate shocks, and be sensitive to the patient with multiple shocks and consider offering additional psychological support."

SOURCE: Archives of Internal Medicine, November 12, 2007.