title: Shocktivity: ability and avoidance of daily activity behaviors in ICD patients.
abstract: BACKGROUND
  Implantable cardioverter defibrillator (ICD) shocks terminate potentially life-threatening arrhythmias and may alter patient behavior. Patients are aware of which activities they have the ability to perform, but they may choose to avoid these behaviors after receiving a shock. This study examined ICD patient ability and avoidance of progressively exertive behaviors.
  
  
  METHODS
  ICD patients (N = 443) across the United States were surveyed using an online measure including the 12-item Duke Activity Status Index.
  
  
  RESULTS
  As expected, many patients reported being unable to participate in more physically exertive activities such as strenuous athletic exertion (68.8%), sex (35.4%), and running a short distance (49.0%). Avoidance rates were also relatively high, as patients who reported being able to participate in these activities also reported avoiding them (ie, strenuous athletics, 76.1%). Similarly, the majority of patients reported ability to engage in sexual activity (64.6%) but many chose to avoid sexual activity (51.0%). Multiple reasons were reported for avoidance, including fear of shock, fear of heart rate increase, doctor instruction, no desire, and an "other" option.
  
  
  CONCLUSIONS
  Many ICD patients experience behavioral limitations because of both a perceived inability and preference to avoid exertive activities, and possibly a prescription to do so, particularly strenuous athletic exertion. Clinical and research attention to ICD patient activity levels and reasons for avoidance may improve daily functioning and help patients return to preimplant levels of activity.
authors.affiliation: Departments of Psychology (Mss Cutitta and Ford, Mr Woodrow, and Dr Sears), Psychiatric Medicine (Dr Hazelton), and Cardiovascular Sciences (Dr Sears), East Carolina University, Greenville, North Carolina; Brigham and Women's Hospital, Boston, Massachusetts (Ms Shea); and Mount Sinai School of Medicine, New York City, New York (Dr Fischer).
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Cutitta
authors.forename: Lawrence K
authors.initials: LK
authors.lastname: Woodrow
authors.forename: Jessica
authors.initials: J
authors.lastname: Ford
authors.forename: Julie
authors.initials: J
authors.lastname: Shea
authors.forename: Avi
authors.initials: A
authors.lastname: Fischer
authors.forename: Garrett
authors.initials: G
authors.lastname: Hazelton
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Sears
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000628:therapy; D054874:Athletic Performance / Q000502:physiology / Q000523:psychology; D017147:Defibrillators, Implantable / Q000523:psychology*; D004554:Electric Countershock / Q000295:instrumentation / Q000523:psychology; D004924:Escape Reaction; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology / Q000523:psychology; D018434:Sickness Impact Profile; D014481:United States / Q000453:epidemiology