More than one in ten patients affected by anxiety and depression following ICD implantation

A recent study published in EP Europace has revealed a high prevalence of depression and anxiety in patients with implantable cardioverter defibrillators (ICDs), particularly in those who experience shocks. The study also flagged concerns about the prevalence of post-traumatic stress disorder (PTSD) following ICD implantation.

Researchers found that nearly one-third of ICD patients experienced anxiety in the first year, while one in five experienced depression. The study, conducted by the University of South Australia, highlighted the need for psychological assessment and therapy to be integrated into the routine care of ICD patients.

ICDs are recommended for individuals at high risk of life-threatening heart rhythms and cardiac arrest, and anxiety and depression have been linked to a higher likelihood of premature death in these patients. The study analyzed data from 109 studies covering 39,954 ICD patients and found prevalence rates of anxiety, depression, and PTSD to be significantly higher compared to the general population.

Furthermore, the study revealed that patients who received shocks from their ICD were four times more likely to experience anxiety and nearly twice as likely to experience depression compared to those who did not receive shocks. Women were also found to be more likely to experience anxiety after receiving an ICD.

The decline in mood disorders over time may be due to a variety of factors, including psychological help and patient adaptation to their new life. However, the researchers noted that it is also possible that healthier individuals are more likely to stay in studies, while those with poorer health may be more likely to drop out.

Overall, the study emphasizes the importance of addressing mental health concerns in ICD patients and highlights the need for continued research in this area.

Regarding non-ICD participants in the 109 studies, the analysis also examined mood disorders. It was found that approximately 23% of partners of ICD patients experienced anxiety following the implantation, and 14% experienced depression, which were similar rates to the patients themselves. Additionally, patients with cardiac disease but without an ICD had similar rates of mood disorders as those with an ICD.

Professor Keage noted that partners of ICD patients are understandably concerned about their loved one undergoing surgery and the possibility of receiving a shock. Including ICD patient partners in psychological therapies has been shown to improve both the physical and psychological health of patients more effectively than attending therapy alone. The findings in cardiac patients align with expectations, as there is a well-known link between heart health and mood disorders. Psychological distress can also contribute to heart problems through chronic stress and unhealthy lifestyles. The involvement of psychologists in the care of cardiac patients is currently limited, but Professor Keage stressed the need for change in this regard. She encouraged patients and partners to seek help if they experience low mood or excessive worry, as evidence-based therapies for anxiety, depression, and PTSD are available.