Quality of life, depression, and anxiety in patients with a subcutaneous versus transvenous defibrillator system

Abstract

Background Use of the subcutaneous implantable defibrillator (S‐ICD) has increased because the device received US Food and Drug Administration approval in 2012, but we still know little about whether the quality of life (QoL) of patients with an S‐ICD versus a transvenous ICD (TV‐ICD) is comparable. We compared S‐ICD patients with TV‐ICD patients on QoL, depression, and anxiety up to 12 months’ follow‐up. Methods A matched cohort of S‐ICD (N = 167) and TV‐ICD patients (N = 167) completed measures on QoL, depression, anxiety, and personality at baseline, 3, 6, and 12 months post implant. Data were analyzed using multivariable modeling with repeated measures. Results In adjusted analyses, we found no statistically significant differences between cohorts on physical and mental QoL and depression (all Ps > .05), while S‐ICD patients reported lower anxiety than TV‐ICD patients (P = 0.0007). Both cohorts experienced improvements in physical and mental QoL and symptoms of depression and anxiety over time (all Ps < .001), primarily between implant and 3 months. These improvements were similar for both cohorts with respect to physical and mental QoL and anxiety (Ps > .05), while S‐ICD patients experienced greater reductions in depressive symptoms (P = .0317). Conclusion The QoL and depression levels were similar in patients with an S‐ICD and a TV‐ICD up to 12 months’ follow‐up, while S‐ICD patients reported lower anxiety levels and a greater reduction in depression over time as compared to TV‐ICD patients. This knowledge may be important for patients and clinicians, if the indication for implantation allows both the S‐ICD and the TV‐ICD, making a choice possible.

Patient acceptance of subcutaneous versus transvenous defibrillator systems: A multi‐center experience

“…16,25 Data have been previously published on the quality of life of S-ICD patients. [26][27][28] Specifically, similar quality of life was found in S-ICD and transvenous ICD patients up to 6-and 12-months follow-up. 27,28 Moreover, while no differences were found between groups on psychological disorders and mental quality of life, physical quality of life seemed more impaired in transvenous ICD patients.…”

“…[26][27][28] Specifically, similar quality of life was found in S-ICD and transvenous ICD patients up to 6-and 12-months follow-up. 27,28 Moreover, while no differences were found between groups on psychological disorders and mental quality of life, physical quality of life seemed more impaired in transvenous ICD patients. 26 However, currently no study has evaluated patient acceptance of S-ICD as a patient-centered outcome.…”

Patient acceptance: Metrics, meaning, and the “missing piece” in evaluating novel devices

“…Previous observational research comparing S-ICD to TV-ICDs have yielded mostly comparable findings on generic QOL and general psychological functioning. 10,11 Both groups reported improvements by the 3-month mark and had sustained those improvements at 12-month follow up. Additionally, lower rates of anxiety and a greater reduction of depressive symptoms in the S-ICD group were noted.…”

“…Additionally, lower rates of anxiety and a greater reduction of depressive symptoms in the S-ICD group were noted. 11 The use of device-specific QOL metrics (i.e., ICD QoL questionnaire) demonstrated that S-ICD patients had more severe perioperative pain, but were comparable on other aspects. 12 Vincentino et al (2022) 1 adds to this literature by further demonstrating that S-ICD patients accept their ICD as well as, if not better than, the TV-ICD patients.…”

An Evaluation of the Association between Quality of Life and Psychological Issues in Patients with Automated Implantable Cardioverter Defibrillator

“…1 Implantable cardioverter defibrillator (ICD) is among such progresses in therapeutic technologies. 2 Evidence has indicated that ICD is superior to antidysrhythmic medications in reducing deaths resulting from cardiac dysrhythmias, as well as the risk of sudden cardiac death. 3 Moreover, ICD implantation has undergone considerable progresses in the recent years.…”