The Quality Of Life And Shock Experience In Patients With Implantable Cardioverter Defibrillator

Background:Implantable Cardioverter Defibrillator (ICD) reduces the mortality of the sudden cardiac death (SCD). But, it also brought some problems after it was inserted into patients, especially patients who experienced the ICD shock may suffer serious mental distress. So more and more foreign scholars gave attention to the patient’s quality of life and their experience after the ICD implant at abroad, but in China there is less study about these aspects. Quality of life situation and its influence factors in patients with ICD are unclear, which are needed to investigate.Objectives:(1) to describe quality of life in patients with the ICD, (2) to discuss the influence factors of the quality of life, (3) to describe the ICD-shock experience of the patients.Methods:This study was a cross-sectional research design which adopted questionnaire survey combined with semi-structured interview.100 patients with ICD were recruited from Fuwai cardiovascular hospital on March 2014 to March 2015.They finished 12-Item Short-Form Health Survey Questionnaire (SF-12), Florida Patient Acceptance Survey (FPAS), Florida Shock Anxiety Scale (FSAS), Type D Scale (DS-14) and general information questionnaire.21 patients who had experienced ICD-shock were interviewed in-depth using the semi-structured interview.Results:(1) The average age of 100 patients were 53.32±13.70 years, predominantly male (73%).52% of patients’ LVEF was less than 50%,38% of patients had experienced ICD shock, and 20% of patients had experienced more than five shocks. The mean scores of physical component summary (PCS) and mental component summary (MCS) of ICD patients (43.55 and 47.07, respectively) were lower than the Chinese general population (P<0.001) and the chronic heart failure patients (P<0.001). (2) Multiple linear regression analysis indicated that FPAS-total and LVEF accounted for 23.2% of the total variance in physical component summary (PCS), FPAS-total and type D personality accounted for 34.5% of the total variance in mental component summary (MCS).(3) Through Colaizzi’s 7 step analysis six themes were found, including:there were cardiovascular system symptoms before shock; seriously perceived when ICD shocked; different action after shock; dealing with themselves after experiencing multiple shocks; different adaptability; faced with multiple challenges.Conclusion:This study showed that the quality of life in patients with ICD was lower than Chinese general population and patients with heart failure. Medical staff should give more attention to their quality of life. The factors that affected the quality of life included equipment acceptance, ejection fraction and type D personality. Patients perceived ICD shock seriously. Some patients responsed ICD shock negatively, some patients gradually adapted to the equipment. But some patients still faced psychological pressure and multiple challenges.