Prevention of implantable defibrillator shocks by cognitive behavioral therapy: A pilot trial

Chevalier, Philippe; Cottraux, Jean; Mollard, Evelyne; Sai, NanYao; Brun, Sophie; Burri, Haran; Restier, Lioara; Adeleine, P.

doi:10.1016/j.ahj.2005.10.007

Cited by 73 publications

(122 citation statements)

References 28 publications

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“…Anxiety and depression scores were improved, but these findings were not statistically significant. Similarly, Chevalier et al 52 (nϭ70) compared 6 sessions of CBT with usual care, with shock occurrence as the dependent variable. The CBT group had fewer shocks and lower anxiety at 3-month follow-up.…”

Section: Effective Psychosocial Care For Icd Patientsmentioning

confidence: 99%

Posttraumatic Stress and the Implantable Cardioverter-Defibrillator Patient

Sears

Hauf

Kirian

et al. 2011

Circ: Arrhythmia and Electrophysiology

118

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he implantable cardioverter-defibrillator (ICD) has revolutionized the care of patients at risk for life-threatening arrhythmias. Large-scale clinical trials established mortality benefits for the ICD over usual care or medications 1,2 and led to wider use for both primary and secondary prevention indications. More recent research confirms that the mortality benefits of the ICD extend over 8-year follow-up when compared with usual care. 3 These clinical trial successes, in terms of mortality, have allowed for greater focus on patientcentered outcomes, such as quality of life, device acceptance, psychological well-being, and trauma reactions in research and clinical care. 4 Shock has been a primary focus in this work because of its potentially traumatic impact on the patient experience. Although there is mixed evidence on the effect of single ICD shocks, 5,6 the literature consistently supports the negative impact of Ͼ5 shocks on quality of life and emotional distress. 7,8 ICD shock has been a focus of research interest because it is a unique experience for the ICD patient and can be perceived as a traumatic event. In addition, the existence of concomitant heart disease, angina, congestive heart failure, or previous sudden death may create sensitivity to traumatic stress that warrants improved understanding by attending electrophysiologists. Although psychological distress in ICD patients has been explored, the possibility that some ICD patients have trauma reactions, up to and including posttraumatic stress disorder (PTSD), has garnered increased attention recently. Therefore, the purposes of this report are to highlight the theory and research addressing psychological distress including PTSD in electrophysiology clinics, to discuss clinical management of these sequelae, and to suggest areas of future research and development. Psychosocial Distress of ICD Patients in Electrophysiology ClinicsPrevention and identification of distress in ICD patients represents comprehensive, high-quality care, regardless of the cause (eg, depression, anxiety, trauma), consistent with the biopsychosocial model of care. 9 This model of care entails the conceptualization and treatment of health problems as an interplay between biological factors, psychological factors, and social factors culminating in the manifestation of symptoms. For an electrophysiologist, these ambitious goals can include prevention of distress through cardiac care and education, recognition of distress warranting referral, optimizing quality-of-life (QoL) outcomes, and promoting patient acceptance of the ICD. Clearly, these are not easily accomplished without sufficient awareness, clinical support, and interdisciplinary expertise. Below are some key considerations for daily clinical practice. Prevalence and Impact of Psychosocial DistressGeneral or ICD-specific anxiety as a psychological morbidity has a point prevalence of 13% to 38% of ICD recipients in cross-sectional research. 4 Longitudinal assessment of anxiety has indicated that approximately 35% of pati...

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Section: Effective Psychosocial Care For Icd Patientsmentioning

confidence: 99%

Posttraumatic Stress and the Implantable Cardioverter-Defibrillator Patient

Sears

Hauf

Kirian

et al. 2011

Circ: Arrhythmia and Electrophysiology

118

View full text Add to dashboard Cite

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“…Given the positive outcomes of studies using cognitive behavioral training and techniques, 160,163,166,167,169,170 clinicians are encouraged to incorporate these strategies into their communication, education, and support activities for ICD patients. Formal CBT may involve a series of 8 to 10 individual or group sessions for those who are clinically anxious and/or depressed and referred to a trained provider.…”

Section: End Of Lifementioning

confidence: 99%

“…162 The outcomes of the interventions were measured from 3 to 12 months after the intervention, with long-term benefits of psychosocial interventions noted in 5 studies at 12 months. 33,70,165,166,170 More than two thirds of the interventions tested were based on a cognitive behavioral therapy (CBT) framework. The length of CBT interventions ranged from 4 to 12 sessions, with the majority including 6 sessions.…”

Section: Psychological-educational Interventions After An Icdmentioning

confidence: 99%

Educational and Psychological Interventions to Improve Outcomes for Recipients of Implantable Cardioverter Defibrillators and Their Families

et al. 2012

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Abstract-Significant mortality benefits have been documented in recipients of implantable cardioverter defibrillators (ICDs); however, the psychosocial distress created by the underlying arrhythmia and its potential treatments in patients and family members may be underappreciated by clinical care teams. The disentanglement of cardiac disease and device-related concerns is difficult. The majority of ICD patients and families successfully adjust to the ICD, but optimal care pathways may require additional psychosocial attention to all ICD patients and particularly those experiencing psychosocial distress. This state-of-the-science report was developed on the basis of an analysis and critique of existing science to (1) describe the psychological and quality-of-life outcomes after receipt of an ICD and describe related factors, such as patient characteristics; (2) describe the concerns and educational/informational needs of ICD patients and their family members; (3) outline the evidence that supports interventions for improving educational and psychological outcomes for ICD patients; (4) provide recommendations for clinical approaches for improving patient outcomes; and (5) identify priorities for future research in this area. The ultimate goal of this statement is to improve the precision of identification and care of psychosocial distress in ICD patients to maximize the derived benefit of the ICD. (Circulation. 2012;126:2146-2172.)Key Words: AHA Scientific Statements Ⅲ anxiety Ⅲ depression Ⅲ implantable cardioverter defibrillator Ⅲ patient education Ⅲ patient outcomes assessment Ⅲ psychological responses Ⅲ quality of life F or patients who receive an implantable cardioverter defibrillator (ICD) for primary or secondary prevention of life-threatening ventricular arrhythmias, the initial experiences related to care for cardiac arrhythmias and ICD therapy are often dramatic. This is especially true if the index event is a sudden cardiac arrest (SCA). Additionally, many patientsThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on July 26, 2012. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The American Heart Association requests that this document be cited as follows: Dunbar SB, Dougherty CM, Sears SF, Carroll DL, Goldstein NE, Mark DB, McDaniel G, Pressler SJ, Schron E, Wang P, Zeigler VL; on behalf of the American Heart As...

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“…34 Each option or their combination can potentially affect the incidence of arrhythmia in rather unpredictable ways. Antidepressants, ECT, and vagus nerve stimulation have possible arrhythmogenic effects, [35][36][37][38][39][40] yet, psychotherapy, such as biofeedback 41 and cognitive behaviour therapy, 42 can decrease the incidence of arrhythmia in cardiac patients.…”

Section: Résumémentioning

confidence: 99%