Background Ventricular arrhythmias (VAs) and their treatment have been associated with psychological distress and diminished quality of life (QOL). We administered a battery of patient‐reported outcome measures (PROMs) to patients seeing an electrophysiologist and psychologist in a multidisciplinary VA clinic for patients referred for consideration of catheter ablation for sustained VAs or implantable cardioverter‐defibrillator therapies. Methods and Results In this retrospective study of the initial VA clinic visit, we analyzed PROMs of: anxiety and depression symptoms, visual analog scales for physical health status and quality of life, cardiac anxiety, implantable cardioverter‐defibrillator acceptance, and implantable cardioverter‐defibrillator shock anxiety. We quantitated baseline PROM score means and performed correlation analysis with clinical makers of cardiac and VA disease severity. We also performed an item‐level analysis of each PROM question to quantify most frequent patient concerns. A total of 66 patients (56±15 years; 77% men) were included; 70% had prior implantable cardioverter‐defibrillator shock, and 44% with prior VA ablation. Elevated symptoms of anxiety (53%) and depression (20%) were common. Younger patients had greater symptom burden of general health anxiety, cardiac anxiety, and shock anxiety, and lower device acceptance, but indices of VA burden such as number of ICD shocks and time since last ICD shock did not predict anxiety or depression. Item‐level review of cardiac‐specific PROMs revealed that >40% of patients expressed concern regarding resumption of physical activity, sex and employment. Conclusions Clinicians can expect elevated symptoms of depression, and cardiac and device‐related anxiety among patients with VAs. Routine use of PROMs may elicit these symptoms, which were otherwise not predicted by arrhythmia burden.  Review of individual PROM items can facilitate targeting specific patient concerns, which commonly involved physical activity.

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Background: Ventricular arrhythmias (VAs) and their treatment have been associated with psychological distress and poorer quality of life (QOL) in research studies. Patient-reported outcome (PRO) measures are beginning to be introduced in clinical settings and early experiences with their clinical utility warrant attention. We wanted to describe PROs of patients attending a multidisciplinary VA clinic in order to elucidate roles that PRO measures might have in clinical settings. Methods: In this retrospective study, we enrolled patients with history of sustained VA and/or ICD shock at their initial visit to a clinic staffed by an electrophysiologist and a psychologist. Patients completed several PRO measures including the following: anxiety and depression symptoms, visual analog scales for health status and QOL, cardiac device acceptance, ICD shock anxiety, and general cardiac anxiety. Here we report total scores for general PROs and item-level analysis of the three cardiac-specific measures. Results: A total of 57 patients (56 ±15 years; 84% male) were included; 39% had a history of sudden cardiac arrest, 70% had prior ICD shock and 44% had previously undergone VA ablation. Symptoms that exceeded clinical thresholds were common for anxiety (49%) and depression (20%). On 0-100 visual analogue scales, the mean rating for health status was 57 ± 16 and for QOL was 66 ± 18. Item-level analysis of cardiac-specific PROs revealed that between 40% and 50% of patients endorsed specific concerns regarding return to work, resumption of physical activities, and sexual relations (Table 1). Conclusion: Among patients attending a VA clinic, elevated symptoms of anxiety and depression were common and self-reported health status and QOL were low. Although PRO total scores provided general information, review at the individual item level provided critical information about potential sources of anxiety that can guide cardiologists during discussions with patients.

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