Psychological disturbances, adjustment, and the development of phantom shocks in patients with an implantable cardioverter defibrillator.
The implantable cardioverter defibrillator (ICD), approved for use in 1985, is used to treat potentially lethal ventricular arrhythmias by delivering an electrical impulse to the heart to convert the rhythm back to normal. Since that time, newer studies, such as MADIT II and SCD-HeFT, demonstrated the expanding utility of the ICD, which increases the likelihood of every clinician encountering a patient with an ICD. Patients with an ICD face psychological, physical, and social adjustments. Patients with an ICD, in general, have been shown to have high levels of anxiety, depression, and a sense of helplessness. A subset experiences a phenomenon of phantom shock, which may represent a manifestation of anxiety, depression, or other emotional disturbance. It is important to be aware of this phenomenon, as a phantom shock may either represent or contribute to the patient's maladjustment to the ICD. In lieu of specific screening and treatment options for phantom shock at present, we must use a general approach for recognizing patients experiencing this phenomenon.
Liza A. Prudente, MSN, RN, ACNP-C Nurse Practitioner, Electrophysiology, University of Virginia Health System, Charlottesville, Va. 22908, USA.
Liza A
LA
Prudente
D000275:Adjustment Disorders / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D017147:Defibrillators, Implantable / Q000009:adverse effects* / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology; D006801:Humans