Psychosocial impact of implantable cardioverter defibrillators (ICD) in young adults with Tetralogy of Fallot.
OBJECTIVE
To investigate the psychosocial impact of having an implantable cardioverter defibrillator (ICD) in adults with Tetralogy of Fallot (ToF).


METHODS
Included were 26 ToF-patients with an ICD (age 44 ± 12 years), and two control groups consisting of 28 ToF-patients without an ICD (age 40 ± 10 years) and a group of 35 ICD-patients of older age without ToF (age 72.0 ± 8 years). This last control group was chosen to represent the "older general ICD population" with acquired heart disease seen at the out-patient clinic. Psychosocial functioning encompassed daily functioning, subjective health status, quality of life, anxiety, depression, coping and social support.


RESULTS
ToF-patients with ICD showed diminished psychosocial functioning in comparison to ToF-patients without ICD. This was reflected by diminished subjectively perceived physical functioning (p = 0.01), general health perception (p < 0.01) and a lower satisfaction with life (p = 0.02). In comparison to older ICD-patients, ToF-patients with ICD showed less satisfaction with life (p = 0.03), experienced more anxiety (p = 0.01) and showed less favourable coping styles, although physical functioning was better for ToF-patients with ICD than for older ICD-patients (p = 0.01). More inappropriate shocks were found in ToF-patients with ICD compared to the older ICD-patients.


CONCLUSIONS
In patients with ToF, ICD implantation had a major impact on psychosocial functioning which should be taken into account when considering ICD implantation in these young patients. To help improve psychosocial functioning, psychological counselling attuned to the specific needs of these patients may be useful.
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Petra
P
Opić
Elisabeth M W J
EM
Utens
Philip
P
Moons
Dominic A M J
DA
Theuns
Arie P J
AP
van Dijk
Elke S
ES
Hoendermis
Hubert W
HW
Vliegen
Natasja M S
NM
de Groot
Maarten
M
Witsenburg
Martin
M
Schalij
Jolien W
JW
Roos-Hesselink
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001530:Belgium; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000523:psychology*; D003863:Depression / Q000209:etiology; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation / Q000523:psychology*; D004868:Equipment Failure; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D012042:Registries; D012044:Regression Analysis; D012944:Social Support; D013771:Tetralogy of Fallot / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome