Psychiatric Disorders and Quality of Life in Patients With Implantable Cardioverter Defibrillators

Maia, Ana Claudia C. de Ornelas; Soares-Filho, Gastão L.; Pereira, Valeska Martinho; Nardi, Antônio Egídio; Silva, Adriana Cardoso

doi:10.4088/pcc.12r01456

Cited by 22 publications

(14 citation statements)

References 31 publications

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“…This is achieved by applying high-voltage electric shocks to the heart ( Wathen et al, 2004 ). However, such shocks are often associated with severe side effects, such as unwanted tissue damage ( Babbs et al, 1980 ) and the development of mental disorders such as anxiety and depression in patients who experience intense pain and trauma each time the shock is delivered ( Newall et al, 2007 ; de Ornelas Maia et al, 2013 ). Therefore, alternative low-energy approaches for treatment are in great demand.…”

Section: Introductionmentioning

confidence: 99%

Drift and termination of spiral waves in optogenetically modified cardiac tissue at sub-threshold illumination

Hussaini

Venkatesan

Biasci

et al. 2021

eLife

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The development of new approaches to control cardiac arrhythmias requires a deep understanding of spiral wave dynamics. Optogenetics offers new possibilities for this. Preliminary experiments show that sub-threshold illumination affects electrical wave propagation in the mouse heart. However, a systematic exploration of these effects is technically challenging. Here, we use state-of-the-art computer models to study the dynamic control of spiral waves in a two-dimensional model of the adult mouse ventricle, using stationary and non-stationary patterns of sub-threshold illumination. Our results indicate a light-intensity-dependent increase in cellular resting membrane potentials, which together with diffusive cell-cell coupling leads to the development of spatial voltage gradients over differently illuminated areas. A spiral wave drifts along the positive gradient. These gradients can be strategically applied to ensure drift-induced termination of a spiral wave, both in optogenetics and in conventional methods of electrical defibrillation.

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Section: Introductionmentioning

confidence: 99%

Drift and termination of spiral waves in optogenetically modified cardiac tissue at sub-threshold illumination

Hussaini

Venkatesan

Biasci

et al. 2021

eLife

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“…The use of ICDs, including the cardiac resynchronization therapy defibrillator (CRT-D) for patients with heart failure, significantly reduces mortality from sudden cardiac death compared with anti-arrhythmic drug therapy ( Alba et al, 2013 , Chen et al, 2013 , Connolly et al, 2000 , Tan et al, 2014 ). However, some patients with ICDs experience psychological distress due to fear of blast or strong pain by electric shock ( de Ornelas Maia et al, 2013 , Heller et al, 1998 ). According to a recent systematic review, 5–41% of patients reported depressive symptoms and 8–63% reported anxiety symptoms ( Magyar-Russell et al, 2011 ).…”

mentioning

confidence: 99%

Avoidance behavior associated with depressive symptoms in patients with implantable cardioverter defibrillators

Ichikura

Kobayashi

Matsuoka

et al. 2017

International Journal of Clinical and Health Psychology

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Objective: Many patients with implantable cardioverter defibrillators experience depressive symptoms. In addition, avoidance behavior is a common problem among patients with implantable cardioverter defibrillators. We examined the association between avoidance behaviors and depressive symptoms in patients with implantable cardioverter defibrillators. Method: We conducted a single-center, cross-sectional study with self-completed questionnaires between May 2010 and March 2011. We measured avoidance behaviors (avoidance of places, avoidance of objects, and avoidance of situations) and depressive symptoms (using the Beck Depression Inventory, Version II) in 119 participants. An avoidance behaviors instrument was developed for this study and we confirmed its internal consistency reliability. Results: Ninety-two (77.3%) patients were aged older than 50 years, and 86 (72.3%) were men. Fifty-one (42.9%) patients reported “avoidance of places”, 34 (28.6%) reported “avoidance of objects”, and 63 (52.9%) reported “avoidance of activity”. Avoidance behavior was associated with increased odds for the presence of depressive symptoms (OR 1.31; 95% CI 1.06–1.62). Conclusions: This was the first study to identify the relationship between avoidance behavior and depressive symptoms among patients with implantable cardioverter defibrillators; however, there are a few methodological limitations.

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“…On the other hand, CIEDs such as implantable cardioverter defibrillators in cardiac patients, while effective for the prevention of sudden death, may have serious psychological effects for both patients and their families. 219,221 Device shocks, which are painful in conscious patients, particularly when frequent, may promote psychiatric side effects such as anxiety and depression and/or may worsen preexisting depressive and anxiety disorders dictating psychiatric intervention. Finally, psychiatric drugs may exacerbate arrhythmias in patients with a CIED leading, for example, to an increased number of device shocks in these patients with their attendant physical and psychological consequences.…”

Section: Prevention and Managementmentioning

confidence: 99%

Cardiovascular Safety of Psychiatric Agents: A Cautionary Tale

Manolis¹,

Manolis

Manolis³

2018

Angiology

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Psychiatric agents are among the most commonly prescribed medications. Despite the advent of newer generation agents, patients receiving them still experience cardiovascular (CV) side effects. However, these agents may have heterogeneous properties, calling for an individualized approach based on efficacy and also on the particular side effect profile of each specific agent. Proarrhythmic effects arising from drug-induced long-QT syndrome and consequent potentially life-threatening polymorphic ventricular arrhythmias in the form of torsade de pointes, the metabolic syndrome contributing to atherosclerosis and acute coronary syndromes, and drug-induced orthostatic hypotension raise major concerns. Of course, it is also crucial that fear of potential CV adverse effects does not deprive psychiatric patients of appropriate drug therapy. Modification of CV risk factors in psychiatric patients together with optimal management of their CV diseases and appropriate selection of psychotropic agents with greater efficacy and least CV toxicity are of paramount importance in mitigating CV risks and enhancing safety. Identifying patients at high risk of CV complications and close monitoring of all patients receiving these agents are crucial steps to prevent and manage such complications. All these issues are herein reviewed, relevant guidelines are discussed, and schemas are depicted that illustrate the interrelated connections among the psychotropic agents and their CV effects.

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Psychiatric Disorders and Quality of Life in Patients With Implantable Cardioverter Defibrillators

Cited by 22 publications

References 31 publications

Drift and termination of spiral waves in optogenetically modified cardiac tissue at sub-threshold illumination

Drift and termination of spiral waves in optogenetically modified cardiac tissue at sub-threshold illumination

Avoidance behavior associated with depressive symptoms in patients with implantable cardioverter defibrillators

Cardiovascular Safety of Psychiatric Agents: A Cautionary Tale

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