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Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy.

Publication ,  Journal Article
Perini, AP; Kutyifa, V; Veazie, P; Daubert, JP; Schuger, C; Zareba, W; McNitt, S; Rosero, S; Tompkins, C; Padeletti, L; Moss, AJ
Published in: Am Heart J
July 2017

UNLABELLED: Effects of implantable cardioverter/defibrillator (ICD) shocks and antitachycardia pacing (ATP) on anxiety and quality of life (QoL) in ICD patients are poorly understood. METHODS: We evaluated changes in QoL from baseline to 9-month follow-up using the EQ-5D questionnaire in patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) (n=1,268). We assessed anxiety levels using the Florida Shock Anxiety Scale (1-10 score) in patients with appropriate or inappropriate shocks or ATP compared to those with no ICD therapy during the first 9 months postimplant. The analysis was stratified by number of ATP or shocks (0-1 vs ≥2) and adjusted for covariates. RESULTS: In MADIT-RIT, 15 patients (1%) had ≥2 appropriate shocks, 38 (3%) had ≥2 appropriate ATPs. Two or more inappropriate shocks were delivered in 16 patients (1%); ≥2 inappropriate ATPs, in 70. In multivariable analysis, patients with ≥2 appropriate shocks had higher levels of shock-related anxiety than those with ≤1 appropriate shock (P<.01). Furthermore, ≥2 inappropriate shocks produced more anxiety than ≤1 inappropriate shock (P=.005). Consistently, ≥2 appropriate ATPs resulted in more anxiety than ≤1 (P=.028), whereas the number of inappropriate ATPs showed no association with anxiety levels (P=.997). However, there was no association between QoL and appropriate or inappropriate ATP/shock (all P values > .05). CONCLUSIONS: In MADIT-RIT, ≥2 appropriate or inappropriate ICD shocks and ≥2 appropriate ATPs are associated with more anxiety at 9-month follow-up despite no significant changes in the assessment of global QoL by the EQ-5D questionnaire. Innovative ICD programming reducing inappropriate therapies may help deal with patient concerns about the device.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2017

Volume

189

Start / End Page

75 / 84

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Tachycardia, Ventricular
  • Surveys and Questionnaires
  • Risk Factors
  • Quality of Life
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

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Perini, A. P., Kutyifa, V., Veazie, P., Daubert, J. P., Schuger, C., Zareba, W., … Moss, A. J. (2017). Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy. Am Heart J, 189, 75–84. https://doi.org/10.1016/j.ahj.2017.03.009
Perini, Alessandro Paoletti, Valentina Kutyifa, Peter Veazie, James P. Daubert, Claudio Schuger, Wojciech Zareba, Scott McNitt, et al. “Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy.Am Heart J 189 (July 2017): 75–84. https://doi.org/10.1016/j.ahj.2017.03.009.
Perini AP, Kutyifa V, Veazie P, Daubert JP, Schuger C, Zareba W, et al. Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy. Am Heart J. 2017 Jul;189:75–84.
Perini, Alessandro Paoletti, et al. “Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy.Am Heart J, vol. 189, July 2017, pp. 75–84. Pubmed, doi:10.1016/j.ahj.2017.03.009.
Perini AP, Kutyifa V, Veazie P, Daubert JP, Schuger C, Zareba W, McNitt S, Rosero S, Tompkins C, Padeletti L, Moss AJ. Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT-RIT substudy. Am Heart J. 2017 Jul;189:75–84.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2017

Volume

189

Start / End Page

75 / 84

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Tachycardia, Ventricular
  • Surveys and Questionnaires
  • Risk Factors
  • Quality of Life
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies