Quality of life among implantable cardioverter-defibrillator recipients in the primary prevention therapeutic era.
BACKGROUND
Although patients receiving implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden cardiac death are the fastest growing segment of the ICD recipient population, the quality-of-life (QOL) effects of the ICD among primary prevention patients are not well understood. The purpose of this study was to measure and compare the health-related QOL among primary and secondary prevention ICD recipients, and to determine predictive factors for high or low QOL in each group.


METHODS
Forty-five primary prevention and 75 secondary prevention ICD recipients receiving routine care in electrophysiology clinics within the University of Pennsylvania Health System were assessed using several well-validated general and ICD-specific QOL instruments.


RESULTS
Between primary and secondary prevention patients, there were no significant differences in EuroQol 5D (medians: 0.84 vs 0.84, P = 0.71), Health Utilities Index (medians: 0.88 vs 0.85, P = 0.95), Short Form-12 aggregate physical summary (means: 45 vs 46, P = 0.64), and Short Form-12 aggregate mental summary (means: 46 vs 47, P = 0.93) scores. Both primary and secondary prevention patients viewed their devices favorably according to the Florida Patient Acceptance Survey scale, with no significant differences between group means (80 vs 83, P = 0.71). However, substantial fractions of both primary and secondary prevention recipients had particular concerns about lifting (40%), sexual activity (19%), and driving (14%).


CONCLUSIONS
QOL does not significantly differ between primary prevention and secondary prevention ICD recipients. Device recipients had comparable QOL to published, nationwide QOL estimates among non-ICD patients of similar age. The ICD was highly acceptable to most primary and secondary prevention patients.
Groeneveld
Peter W
PW
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA. peter.groeneveld@va.gov
Matta
Mary A
MA
Suh
Janice J
JJ
Yang
Feifei
F
Shea
Judy A
JA
D000368:Aged; D015897:Comorbidity; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D011788:Quality of Life; D011795:Surveys and Questionnaires