Heart-focused anxiety in patients with chronic heart failure before implantation of an implantable cardioverter defibrillator: baseline findings of the Anxiety-CHF Study.
OBJECTIVE
We analysed heart-focused anxiety (HFA) and its predictors in patients with heart failure before implantation of an implantable cardioverter defibrillator (ICD). Herein, we report the baseline data of the Anxiety-CHF Study which investigates HFA before and after ICD implantation.


RESULTS
HFA, general anxiety and depression, perceived quality of life (QoL) and type D personality were measured with validated psychological instruments. Clinical parameters such as severity of heart failure measured by NYHA class and left ventricular ejection fraction (EF) were determined. One hundred and ten patients were interrogated before ICD implantation (70 % male, mean age = 60.5 ± 14.9 years, mean EF = 31 % ± 9 %, 91 % NYHA II-III, 92 % primary prevention). HFA was present in 53 patients (48.6 %); 37 participants (33.9 %) showed increased levels of general anxiety and 33 patients (30.3 %) showed increased levels of depression with clinical significant levels in 16 subjects (14.7 %) for general anxiety and 13 subjects (11.9 %) for depression. Poor QoL was reported in 30 patients (27.5 %). HFA was correlated with QoL, general anxiety, depression, type D personality, myocardial infarction (MI), and systolic blood pressure. QoL, general anxiety and former MI were significant predictors of HFA (R (2) = 0.453).


CONCLUSIONS
Heart-focused anxiety is highly prevalent in heart failure patients prior to ICD implantation. Measures of disease severity such as EF or NYHA class do not predict HFA, neither does Type D personality. HFA is predicted by a history of MI and psychological parameters such as general anxiety and impaired QoL. CLINICALTRIALS.
NCT02226770.
Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. Maxie.Bunz@uks.eu.
Maxie
M
Bunz
Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.|Psychotherapy Practice, Saarbrücken, Germany.
Denise
D
Lenski
Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
Sonja
S
Wedegärtner
Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
Christian
C
Ukena
Institut für Psychologie, Goethe-Universität, Frankfurt, Germany.
Julia
J
Karbach
Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
Michael
M
Böhm
Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. ingrid.kindermann@uks.eu.
Ingrid
I
Kindermann
D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D064415:Type D Personality
CRT-D; Heart-focused anxiety; ICD; Psychological factors; Quality of life; Type D personality