title: Do patients accept implantable atrial defibrillation therapy? Results from the Patient Atrial Shock Survey of Acceptance and Tolerance (PASSAT) Study.
abstract: BACKGROUND
  The Medtronic Jewel AF 7250 is an implantable cardioverter defibrillator with atrial and ventricular therapies (ICD-AT). The ICD-AT is effective in managing atrial tachyarrhythmias (atrial fibrillation [AF]), but patient acceptance remains an issue. This aim of this study was to measure ICD-AT acceptance.
  
  
  RESULTS
  ICD-AT acceptance was evaluated in 96 patients enrolled in the "Jewel AF-AF-Only Study" for > or =3 months of follow-up (mean 19 months). Patients were mostly men (72%; age 65 +/- 12 years). Clinical data and a written survey (75% response rate) were used to quantify demographics, AF frequency and symptoms, atrial defibrillation therapy, quality of life (QOL), psychosocial distress, and ICD-AT therapy acceptance. From implant to survey, AF symptom and severity scores decreased by 18% (P < or = 0.05), and QOL (SF-36) scores increased by 15% to 50% (P < or = 0.05). ICD-AT therapy acceptance was high, with 71.3% of patients scoring in the 75th percentile on the Florida Patient Acceptance Survey. ICD-AT acceptance was correlated with the Physical Component Scale and Mental Health Component Scale scores of the SF-36 (r = 0.28 and 0.35, respectively). ICD-AT acceptance was negatively correlated with depressive symptomatology (r =-0.59), trait anxiety (r =-0.48), illness intrusiveness (r =-0.55), and AF symptom and severity scores (r =-0.26). ICD-AT acceptance did not correlate with preimplant cardioversions, number of atrial shocks, AF episodes detected by the device, or device implant duration.
  
  
  CONCLUSIONS
  Most patients accepted ICD-AT therapy. Patients were more likely to accept ICD-AT if they had less psychosocial distress, greater QOL, and lower AF symptom burden.
authors.affiliation: Department of Clinical Health Psychology, University of Florida, Gainesville, Florida 32610, USA.
authors.forename: Jason L
authors.initials: JL
authors.lastname: Burns
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Sears
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sotile
authors.forename: David S
authors.initials: DS
authors.lastname: Schwartzman
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hoyt
authors.forename: Luis G
authors.initials: LG
authors.lastname: Alvarez
authors.forename: Michael R
authors.initials: MR
authors.lastname: Ujhelyi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000523:psychology / Q000628:therapy*; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D003625:Data Collection; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D018434:Sickness Impact Profile; D013223:Statistics as Topic; D016896:Treatment Outcome