title: Sexual concerns and practices after ICD implantation: findings of the COPE-ICD rehabilitation trial.
abstract: BACKGROUND
  Studies show that patients with implantable cardioverter defibrillators (ICD) frequently experience sexual dysfunction. These experiences are often linked to exercise intolerance, side-effects of medication, and psychological problems.
  
  
  OBJECTIVE
  To describe (a) the level of information given about sexual activity, (b) the areas of patient concerns related to sexual function and the ICD, and (c) changes in sexual behavior.
  
  
  METHODS
  A randomized controlled trial including 196 patients (1:1) was designed, including 12 weeks of exercise training and 1 year of psycho-educational follow-up focusing on modifiable factors associated with poor outcomes, including sexual functioning. The Sex After ICD Survey was administered 6 months after the randomization as part of the planned explorative outcomes. 141 patients responded.
  
  
  RESULTS
  The analyses showed that 37 of the 69 (55.2%) patients of the intervention group and 16 of the 72 (24.6%) patients of the control group received information (p<0.001). The areas of greatest concern reported by many patients were: lack of interest in sex, erectile dysfunction, and an over-protective partner. Fewer patients were sexually active 6 months after the ICD implantation than before the ICD implant: 51.8% versus 66.7%. In the intervention group, patients had sexual intercourse a mean of 4.9 times during the previous 2 months versus 4.0 in the control group (p=0.4).
  
  
  CONCLUSIONS
  Despite having received more information, no interventional effect was found between groups in terms of sexual concerns or activity.
authors.affiliation: 1The Heart Centre, University of Copenhagen, Denmark.
authors.forename: Selina Kikkenborg
authors.initials: SK
authors.lastname: Berg
authors.forename: Line
authors.initials: L
authors.lastname: Elleman-Jensen
authors.forename: Ann-Dorthe
authors.initials: AD
authors.lastname: Zwisler
authors.forename: Per
authors.initials: P
authors.lastname: Winkel
authors.forename: Jesper Hastrup
authors.initials: JH
authors.lastname: Svendsen
authors.forename: Preben Ulrich
authors.initials: PU
authors.lastname: Pedersen
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation*; D064646:Cardiovascular Nursing / Q000379:methods*; D017147:Defibrillators, Implantable / Q000523:psychology*; D015444:Exercise; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D019145:Rehabilitation Nursing / Q000379:methods; D020018:Sexual Dysfunctions, Psychological / Q000451:nursing / Q000523:psychology*; D019529:Sexuality / Q000523:psychology*
keywords: ICD; comprehensive cardiac rehabilitation; sexual dysfunction