Quality of life and psychological co-morbidities in children and adolescents with cardiac pacemakers and implanted defibrillators: a cohort study in Eastern Germany

Abstract

Introduction:The implantation of a pacemaker or an implantable cardioverter-defibrillator during childhood may reduce quality of life and lead to mental health problems. This study aimed to evaluate potential mental health problems (i.e., depressive and anxiety symptoms) and quality of life in children with cardiac active devices in comparison to healthy peers.Methods:We analysed data of children with pacemakers or implantable cardioverter-defibrillators aged 6–18 years. Quality of life, depressive and anxiety symptoms were assessed by standardised questionnaires. The results were compared to age-matched reference groups.Results:Children with implantable cardioverter-defibrillator showed significant lower quality of life in comparison to reference group (p = 0.03), but there was no difference in quality of life between children with pacemaker and reference group. There was no significant difference in depressive symptoms between children with a cardiac rhythm device compared to reference group (self-report: p = 0.67; proxy report: p = 0.49). There was no significant difference in anxiety (p = 0.53) and depressive symptoms (p = 0.86) between children with pacemaker and children with implantable cardioverter-defibrillator.Conclusions:Living with an implantable cardioverter-defibrillator in childhood seems to decrease the patients’ quality of life. Although children with pacemaker and implantable cardioverter-defibrillator don’t seem to show more depressive and anxiety symptoms in comparison to their healthy peers, there still can be an increased risk for those children to develop mental health problems. Therefore, treating physicians should be aware of potential mental health problems and provide the patients and their families with appropriate therapeutic offers.

Indications and management of implantable cardioverter-defibrillator therapy in childhood hypertrophic cardiomyopathy

“…For the general population of paediatric implantable cardioverter-defibrillator patients, higher levels of anxiety, depression, and sleeping disorders are described, and quality of life is reported to be lower when compared to normative controls and patients with CHD or pacemakers. [124][125][126][127][128][129] A history of implantable cardioverter-defibrillator shocks does not seem to show an association with generic or disease-specific health-related quality of life. 126,130 Conflicting results exist with respect to the experience of implantable cardioverterdefibrillator shocks and depression or anxiety.…”

Adaptation status and related factors in patients living with implantable cardioverter defibrillators

“…Moreover, Ooi et al . [ 29 ] (2016) and Paech[ 30 ] (2020) report low self-esteem in patients living with ICD. These findings reveal the failure in self-consistency and self-ideal after implanting ICD.…”