Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator

Abstract

Several studies have reported improved survival rates thanks to the use of an implantable cardioverter defibrillator (ICD) in the treatment of patients with life-threatening arrhythmia. However, the effects of the ICD on health-related quality of life (HR-QoL) of these patients are not clear. The aim of this study is to describe HR-QoL and fear of exercise in ICD patients. Eighty-nine ICD patients from the University Hospital in Groningen, the Netherlands, participated in this study. HR-QoL was measured using the Rand-36 and the Quality of Life After Myocardial Infarction Dutch language version questionnaires. Fear of exercise was measured using the Tampa Scale for Kinesiophobia, Dutch version and the Fear Avoidance Beliefs Questionnaire, Dutch version. Association between outcome variables was analysed by linear regression analyses. Study results show that the HR-QoL of patients with ICDs in our study population is significantly worse than that of normal healthy people. Furthermore, fear of exercise is negatively associated with HR-QoL corrected for sex, age and number of years living with an ICD. After implantation of the ICD, patients with a clear fear of exercise should be identified and interventions should be considered in order to increase their HR-QoL.

Psychological Intervention to Modify Anxiety, Depression and Quality of Life in Patients with an Implantable Pacemaker

“…It refers how the patient's symptoms and their subsequent therapy affects their ability to perform physical and social activities (Ittersum, Greef, Gelder, Coster, Brugemann, & Schans, 2003;Coelho, Ramos, Prata, Bettencourt, & Ferreira, 2005;García & Calvanese, 2008). Cardiac arrhythmia patients with an implantable device account for lower perceived HRQoL as a consequence of several concerns related to the functioning of the device, and reports psychological comorbidity (depression and anxiety) related to change of body image and life style, limitations in daily activities and physical discomfort (Duru et al, 2001).…”

Psychological vulnerability, ventricular tachyarrhythmias and mortality in implantable cardioverter defibrillator patients: is there a link?

“…Similarly, depression has found to be a strong determinant of all dimensions of subjective fatigue in patients with coronary artery disease [70], which may influence patient motivation to engage in exercise [70]. The lack of exercise may also result from anticipatory anxiety, with ICD patients having a restricted lifestyle because of the fear of a shock [71]. In addition, PTSD has been associated with a higher rate of physical inactivity in terms of overall exercise and self-rated level of exercise in cardiovascular patients [72].…”

Safety Aspects of Implantable Cardioverter Defibrillators in Patients Participating in Exercise Therapy: A Systematic Review and Meta-Analysis

“…Exercise and cardiac rehabilitation also has established benefits in survival, health status, and quality of life in both high and low risk cardiac patients, including those with and without an ICD [4][5][6][7][8]. However, those with an ICD are underrepresented in cardiac rehabilitation, typically report low levels of exercise [9,10] and are often reluctant to participate in exercise programs due to fear of exercise-induced shocks [11,12]. Rates of appropriate and inappropriate ICD therapy vary during follow-up, regardless of activity levels [13], and are both associated with adverse outcomes [14][15][16].…”