The implantable cardioverter defibrillator: its history, current psychological impact and future

Abstract

The innovation of the implantable cardioverter defibrillator (ICD) represents a modern medical achievement with substantial life-saving benefits for patients at risk for potentially life-threatening arrhythmias. Over a decade of research resulted in the first ICD implantation in 1980, dramatically changing the face of cardiac care. The introduction of the device was met by skepticism and outright rejection by some, yet large-scale clinical trials clearly demonstrated the mortality benefit of the ICD. Today, specific challenges for this technology have emerged, including barriers to individual and social acceptance of the ICD as a viable form of technology, as well as psychosocial adjustment difficulties and fears in patients. To address these challenges, scientific research, improved communication regarding devices and psychosocial interventions have been developed and extended to this patient population. As such, it is hypothesized that the future will hold expanding indications for ICD implantation, while further meeting patients' medical and psychosocial adjustment needs. The purposes of this paper are to review the history of ICD innovation, describe past and present research on psychosocial adjustment to the ICD, and corresponding psychosocial interventions, analyze individual and social acceptance and utilization of device technology, and forecast future applications and developments of the ICD.

Assessment of the quality of existing patient educational tools focused on sudden cardiac arrest: a systematic evaluation by the Sudden Cardiac Arrest Thought Leadership Alliance

“…Advancements in the treatment of sudden cardiac arrest (SCA) have been impressive 1. The ability of the implantable cardioverter defibrillator (ICD) to detect and treat potentially fatal arrhythmias demonstrates the power and potential of biomedical technology.…”

Risk of chronic anxiety in implantable defibrillator patients: A multi-center study

“…Anxiety seems to be more prevalent in cardioverter-defibrillator patients than depression, with prevalence rates of anxiety reported from 24-87% compared to 24-33% for depressive symptoms [3]. In the general cardiovascular literature, anxiety has been associated with adverse health outcomes, including decreased quality of life [4] and increased morbidity and mortality [5].…”

Anxiety in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy and Implantable Cardioverter Defibrillators

“…Independent of underlying diagnosis, patients requiring ICDs commonly experience anxiety and/or depression related to the anticipation of a potential shock. 5,6 Psychological implications of ICDs have been reported to be worse in patients with inherited diseases compared with ischemic or valvular heart disease. 7 The experience of receiving 1 or more ICD shocks further negatively affects quality of life.…”