Age‐Specific Differences in Women with Implantable Cardioverter Defibrillators: An International Multi Center Study

Abstract

Women under the age of 50 appear to be at greater risk for the development of psychosocial distress associated with shock anxiety, death anxiety, and body image. Clinical-based strategies and interventions targeting these types of adjustment difficulties in younger women may allow for improved psychosocial and quality of life outcomes.

General and Disease-Specific Psychosocial Adjustment in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy With Implantable Cardioverter Defibrillators: A Large Cohort Study

“…Device-related anxiety (FSAS) scores were worse in our population than others reported (22.9 versus 15.4, 31 14.8, 35 19.9, 30 16.4 22 ). Furthermore, nearly one third had scores consistent with clinically significant anxiety.…”

“…It is notable that our population had worse body image subscale scores than a study reporting ICD experiences of an exclusively female ICD population. 22 As these are the same FPAS subscales in which our youngest cohort had particularly elevated scores, this pattern may reflect the fact that those with ARVD/C require ICD implantation at a younger age than the typical individual with an ICD, since body image concerns have been shown to be associated with younger age. 22 Furthermore, both body image and device-related distress measure concepts thought to be associated with perception of stigma, which can be associated with having an inherited disease.…”

“…22 As these are the same FPAS subscales in which our youngest cohort had particularly elevated scores, this pattern may reflect the fact that those with ARVD/C require ICD implantation at a younger age than the typical individual with an ICD, since body image concerns have been shown to be associated with younger age. 22 Furthermore, both body image and device-related distress measure concepts thought to be associated with perception of stigma, which can be associated with having an inherited disease. Hence, the worse body image and device-related distress subscale scores may be caused, in part, by the genetic etiology of ARVD/C, rather than actual worse cosmetic or device related problems.…”

“…Women are considered to be at higher risk for poor ICD-related adjustment. 22 Finally, patients with ARVD/C may be at particularly high risk because ARVD/C is a genetic disease. This disease etiology by itself raises well-established psychosocial burdens, including anxiety about risks to family members (particularly to children), guilt, blame, and stigmatization.…”

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…Wszczepienie ICD może wpłynąć na wiele dziedzin życia, w tym zdolność prowadzenia samochodu [239,240], relacje intymne [241,242], jakość snu [226], postrzeganie własnego ciała (zwłaszcza u młodszych kobiet) [227] oraz uczestnictwo w zorganizowanych sportach (zwłaszcza u dzieci i młodzieży) [243]. Wsparcie ze strony personelu opieki zdrowotnej zmniejsza te problemy, ale potrzebne są dalsze badania w celu optymalizacji postępów opieki oraz opracowania interwencji opartych na dowodach z badań naukowych [233].…”