Heart patients who receive an implantable cardioverter defibrillator (ICD) should be offered routine screenings and appropriate treatment for anxiety, depression and post-traumatic stress disorder, according to the American Heart Association.
Each month, 10,000 people, including children, have a cardioverter defibrillator implanted to restore normal heart rhythm and prevent sudden cardiac death. Depression, anxiety and post-traumatic stress disorder are common among these patients.
According to a scientific statement from the American Heart Association, improved patient education and ongoing psychological support will help individuals cope with the psychological distress of having an implanted defibrillator.
The statement, published in the American Heart Association journal Circulation, includes recommendations for improved patient care and identifies areas where more research is needed.
“A shock from an ICD can be lifesaving, but it can also affect a person’s quality of life and psychological state,” said Sandra B. Dunbar, R.N., D.S.N., chair of the statement writing group.
“It’s important to look at this issue now because 10,000 people have an ICD implanted each month. They range from older people with severe heart failure to healthy children who have a gene that increases the risk of sudden cardiac arrest.”
Before implantation, patients should be given clear information about the benefits and limitations of the ICD, prognosis and impact on lifestyle including activity and occupation.
“Education and support need to include the patient and the family and be broader than just a focus on maintaining the device. Providers need to help patients address ICD-specific concerns about symptoms, heart disease treatment, physical activities and end-of-life issues,” said Dunbar, of Emory University in Atlanta.
Although less than 1 percent of ICD recipients are children, complications are more common and these patients will live with the defibrillators for a much longer period of time, according to the statement.
“Experiencing a shock is distressing and patients have a wide variety of responses,” Dunbar said. “Some find it very reassuring that it’s working, while others find the actual physical sensations frightening and overwhelming. That’s why we suggest that clinicians provide an ongoing assessment of ICD patients’ psychological needs.”
Source: American Heart Association