Background <p>An implantable cardioverter defibrillator (ICD) is a first-line treatment for ventricular tachycardia (VT); however, ICD shocks are associated with poorer health-related quality of life (HRQoL) and psychological well-being. Clinically, HRQoL and psychological trauma of ICD patients are often severe enough to be offered VT ablation. HRQoL and especially psychological trauma levels have not been evaluated in ICD recipients who underwent a VT ablation as compared to those ICD recipients who were treated medically.</p> Methods <p>61 participants were enrolled. Participants completed measures of global HRQoL [SF-36 Mental Health Component Summary (MCS) and Physical Component Summary], depression and anxiety [Hospital Anxiety and Depression Scale (HADS-A)] and trauma [Impact of Events Scale-Revised (IES-R)] at baseline (recruitment) and 6-months follow-up. Hierarchical regression analyses were employed to assess the hypothesis.</p> Results <p>Regression analyses showed no significant between-group differences on outcome measures. Within-group effects suggested that participants who underwent an ablation improved in mental health HRQoL MCS (<i>p</i> = .002), IES-R Total <i>(p</i> = .005), Intrusion (<i>p</i> = .005) and Hyperarousal (<i>p</i> = .007) subscales. Those who did not undergo an ablation had no improvement in HRQoL, but improved in HADS-A (<i>p</i> = .02), IES-R Total (<i>p</i> = .04), Intrusion (<i>p</i> = .04) and Hyperarousal (<i>p</i> = .02).</p> Conclusion <p>Contrary to hypothesis, significant differences on outcome measures over follow-up were not detected between-groups. Within-group effects suggest better outcomes on HRQoL and emotional distress in ICD recipients who underwent an ablation than those who did not. Lack of between-group differences underscores the need for further study to better understand if and how ablation might improve HRQoL and distress within the ablation subgroup.</p> Graphical Abstract <p>Image sources for graphical abstract: ICD device: <a href="https://www.yashodahospitals.com/implantable-cardioverter-defibrillator-icd-cost-in-india/">https://www.yashodahospitals.com/implantable-cardioverter-defibrillator-icd-cost-in-india/</a>; Heart: <a href="https://www.vecteezy.com/vector-art/11662222-isolated-human-heart-outline-sketch">https://www.vecteezy.com/vector-art/11662222-isolated-human-heart-outline-sketch</a>; Hospital: <a href="https://www.clipartbest.com/cartoon-hospital-building">https://www.clipartbest.com/cartoon-hospital-building</a>; Questionnaire: <a href="https://clipart-library.com/clipart/questionnaire-cliparts_10.htm">https://clipart-library.com/clipart/questionnaire-cliparts_10.htm</a>; Statistics: Statistics, Data, Trends, Research, Metrics PNG .</p> <p></p>

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Psychological trauma and health-related quality of life following ventricular tachycardia ablation

  • Ana Bilanovic,
  • Jane Irvine,
  • Andreu Porta-Sánchez,
  • Benjamin King,
  • Paul Angaran,
  • Paul Dorian,
  • Abhishek Baskaran,
  • Sachin Nayyar,
  • Vivienne Ezzat,
  • Vinit Sawhney,
  • Ann Hill,
  • Sheila Watkins,
  • Zana Mariano,
  • Shruthi Surendran,
  • Dibisha Koirala,
  • Eugene Downar,
  • Kumaraswamy Nanthakumar

摘要

Background

An implantable cardioverter defibrillator (ICD) is a first-line treatment for ventricular tachycardia (VT); however, ICD shocks are associated with poorer health-related quality of life (HRQoL) and psychological well-being. Clinically, HRQoL and psychological trauma of ICD patients are often severe enough to be offered VT ablation. HRQoL and especially psychological trauma levels have not been evaluated in ICD recipients who underwent a VT ablation as compared to those ICD recipients who were treated medically.

Methods

61 participants were enrolled. Participants completed measures of global HRQoL [SF-36 Mental Health Component Summary (MCS) and Physical Component Summary], depression and anxiety [Hospital Anxiety and Depression Scale (HADS-A)] and trauma [Impact of Events Scale-Revised (IES-R)] at baseline (recruitment) and 6-months follow-up. Hierarchical regression analyses were employed to assess the hypothesis.

Results

Regression analyses showed no significant between-group differences on outcome measures. Within-group effects suggested that participants who underwent an ablation improved in mental health HRQoL MCS (p = .002), IES-R Total (p = .005), Intrusion (p = .005) and Hyperarousal (p = .007) subscales. Those who did not undergo an ablation had no improvement in HRQoL, but improved in HADS-A (p = .02), IES-R Total (p = .04), Intrusion (p = .04) and Hyperarousal (p = .02).

Conclusion

Contrary to hypothesis, significant differences on outcome measures over follow-up were not detected between-groups. Within-group effects suggest better outcomes on HRQoL and emotional distress in ICD recipients who underwent an ablation than those who did not. Lack of between-group differences underscores the need for further study to better understand if and how ablation might improve HRQoL and distress within the ablation subgroup.

Graphical Abstract

Image sources for graphical abstract: ICD device: https://www.yashodahospitals.com/implantable-cardioverter-defibrillator-icd-cost-in-india/; Heart: https://www.vecteezy.com/vector-art/11662222-isolated-human-heart-outline-sketch; Hospital: https://www.clipartbest.com/cartoon-hospital-building; Questionnaire: https://clipart-library.com/clipart/questionnaire-cliparts_10.htm; Statistics: Statistics, Data, Trends, Research, Metrics PNG .