QUALITY OF LIFE AND PSYCHOLOGICAL FUNCTIONING OF ICD PATIENTS

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Abstract
Definitive conclusions about QOL differences between patients managed with an ICD and those treated with antiarrhythmic drugs are difficult to make in the absence of large, randomised, controlled trials. Available evidence indicates that ICD recipients experience a brief decline in QOL from baseline but improve to pre-implant levels after one year of follow up.4 The largest clinical trial data published in final form is from the coronary artery bypass graft (CABG) Patch trial which randomised patients to ICD (n = 262) versus no ICD (n = 228) while undergoing CABG surgery.5 In contrast to May and colleagues,4 data from this trial indicate that the QOL outcomes (mental and physical) for the ICD patients were significantly worse compared to patients with no ICD. Subanalyses revealed that there was no difference in QOL for non-shocked ICD patients versus no ICD patients. These results indicated that the ICD group who had received shocks was responsible for the significantly worse mental and physical QOL outcome scores between the groups. Collectively, these data suggest that the experience of shock may contribute to psychological distress and diminished QOL. Figure 1 details the psychological continuum a patient may experience secondary to shock.