Implantable cardioverter defibrillator shocks are prospective predictors of anxiety

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• 作者：Stefan M. Schulz ; PhD^a ; ^b ; ^{schulz@psychologie.uni-wuerzburg.de} ; Claudia Massa ; MD^a ; Anna Grzbiela ; MD^c ; Wilhelm Dengler ; MD^d ; Georg Wiedemann ; MD^e ; ^f ; Paul Pauli ; PhD^a ; ^b ; ^{pauli@psychologie.uni-wuerzburg.de}
• 关键词：Implantable cardioverter defibrillator ; ICD-shock ; Anxiety ; Prospective predictor ; Conditioning ; Cognitive model
• 刊名：Heart Lung: The Journal of Acute and Critical Care
• 出版年：2013
• 出版时间：March-April, 2013
• 年：2013
• 卷：42
• 期：2
• 页码：105-111
• 全文大小：255 K

文摘

Objectives

To examine the temporal contingency of anxiety and implantable cardioverter defibrillator (ICD) therapy (anti-tachycardia-pacing and shocks to prevent ventricular tachycardia and/or fibrillation).

Background

It is under debate whether anxiety is a precursor and/or consequence of ICD-therapy.

Methods

In a prospective longitudinal study, fifty-four patients undergoing first-time ICD-implantation were assessed for anxiety, frequency of ICD-shocks and anti-tachycardia-pacing up to two days before ICD-implantation (T0) and twelve months later (T1).

Results

Anxiety at T0 did not predict frequency of ICD-shocks at T1, but ICD-shocks significantly predicted increased anxiety at T1. In contrast, anxiety at T0 and T1 was unrelated to frequency of anti-tachycardia-pacing. Effects remained stable when we controlled for potentially confounding variables (e.g. age, sex, cardiac health and depression at T0).

Conclusion

Our findings indicate that repeated ICD-shocks are a cause of anxiety in ICD-patients rather than a consequence, thus shock frequency should be minimized.