Quality‐of‐Life Six Months After CABG Surgery in Patients Randomized to ICD Versus No ICD Therapy: Findings from the CABG Patch Trial

Namerow, Pearila Brickner; Firth, Beverly; Heywood, Geoffrey M.; Windle, John R.; Parides, Michael K.

doi:10.1111/j.1540-8159.1999.tb00623.x

Cited by 129 publications

(101 citation statements)

References 13 publications

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“…The Coronary Artery Bypass Graft (CABG) Patch Trial examined the value of prophylactic ICD implantation in patients undergoing coronary artery bypass graft surgery (CABG) (n = 262) versus no ICD (n = 228) after CABG surgery. 22 Mental and physical QOL scores for the patients with ICDs were significantly worse compared with those for patients without ICDs. However, further analyses revealed that there was no difference in QOL for nonshocked patients with ICDs versus those with no ICDs.…”

Section: Psychological Adjustment and The Experience Of Shockmentioning

confidence: 85%

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Sears¹,

Conti²

2003

Clinical Cardiology

150

111

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Summary:The experience of shock is the distinguishing feature for patients with implantable cardioverter defibrillators (ICDs) and is associated with diminished psychological functioning and quality of life. Multiple shocks and ICD storm are a relatively common event among patients with ICDs (10-20%) and may present specific challenging medical and psychological management for the attending health care providers. This paper examines the medical and psychological aspects of ICD shocks and storms and describes a model of biopsychosocial management for patients following the experience of ICD storm. Successful management of patients post shock includes the use of antiarrhythmic medications and careful attention to the causality of the shocks via stored electrograms. The psychological management includes specific attention to debriefing post-shock feelings and attributions, preventing avoidance behavior, and facilitating positive "return to life" actions. Preliminary research examining formal psychosocial treatment supports a cognitive behavioral strategy to reduce psychological distress and facilitate quality of life. Collectively, these data suggest that interdisciplinary management of patients with multiple ICD shocks or the experience of ICD storm is advised, and routine psychological consultation may be indicated for the patient post ICD storm to reduce the possibility of symptoms of post-traumatic stress.

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Section: Psychological Adjustment and The Experience Of Shockmentioning

confidence: 85%

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Sears¹,

Conti²

2003

Clinical Cardiology

150

111

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5] Despite differences in the literature between study designs and clinical outcomes, the negative impact of ICD shocks on QoL was consistent between studies and was related to the increased number of shocks received. 3,4 However, whether reduction of shocks by applying ATP therapy improves QoL has not been tested previously. This is the first trial to demonstrate that ATP does improve QoL compared with shock delivery in patients who experience FVT.…”

Section: Discussionmentioning

confidence: 99%

“…Although ICDs are well tolerated by most patients, reports of clinically significant anxiety and depression are common. 1,2 ICD patients receiving shocks exhibit a decline in quality of life (QoL), 3,4 although this finding is not universal. 5 The principal merit of ATP from the patient's perspective is the avoidance of painful shocks.…”

mentioning

confidence: 99%

Prospective Randomized Multicenter Trial of Empirical Antitachycardia Pacing Versus Shocks for Spontaneous Rapid Ventricular Tachycardia in Patients With Implantable Cardioverter-Defibrillators

et al. 2004

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Background-Successful antitachycardia pacing (ATP) terminates ventricular tachycardia (VT) up to 250 bpm without the need for painful shocks in implantable cardioverter-defibrillator (ICD) patients. Fast VT (FVT) Ͼ200 bpm is often treated by shock because of safety concerns, however. This prospective, randomized, multicenter trial compares the safety and utility of empirical ATP with shocks for FVT in a broad ICD population. Methods and Results-We randomized 634 ICD patients to 2 arms-standardized empirical ATP (nϭ313) or shock (nϭ321)-for initial therapy of spontaneous FVT. ICDs were programmed to detect FVT when 18 of 24 intervals were 188 to 250 bpm and 0 of the last 8 intervals were Ͼ250 bpm. Initial FVT therapy was ATP (8 pulses, 88% of FVT cycle length) or shock at 10 J above the defibrillation threshold. Syncope and arrhythmic symptoms were collected through patient diaries and interviews. In 11Ϯ3 months of follow-up, 431 episodes of FVT occurred in 98 patients, representing 32% of ventricular tachyarrhythmias and 76% of those that would be detected as ventricular fibrillation and shocked with traditional ICD programming. ATP was effective in 229 of 284 episodes in the ATP arm (81%, 72% adjusted). Acceleration, episode duration, syncope, and sudden death were similar between arms. Quality of life, measured with the SF-36, improved in patients with FVT in both arms but more so in the ATP arm. Conclusions-Compared with shocks, empirical ATP for FVT is highly effective, is equally safe, and improves quality of life. ATP may be the preferred FVT therapy in most ICD patients.

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“…Analiza QoL była celem substudy tego badania (490 pacjentów 228 z ICD i 262 bez ICD) [21]. Jakość życia, za pomocą SF-36, oceniano 6 miesięcy po zabiegu pomostowania aortalno-wieńcowego (CABG, coronary artery by-pass grafting).…”

Section: Badanie Cabg-patchunclassified

Wpływ kardiowertera-defibrylatora na jakość życia — przegląd badań

et al. 2016

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Quality‐of‐Life Six Months After CABG Surgery in Patients Randomized to ICD Versus No ICD Therapy: Findings from the CABG Patch Trial

Abstract: Strategies aimed at easing patients' adjustment to ICDs should be developed and tested for efficacy in the setting of ICD prophylaxis.

Cited by 129 publications

References 13 publications

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Understanding implantable cardioverter defibrillator shocks and storms: Medical and psychosocial considerations for research and clinical care

Prospective Randomized Multicenter Trial of Empirical Antitachycardia Pacing Versus Shocks for Spontaneous Rapid Ventricular Tachycardia in Patients With Implantable Cardioverter-Defibrillators

Wpływ kardiowertera-defibrylatora na jakość życia — przegląd badań

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