Quality of life in patients with an implantable cardioverter- defibrillator – the significance of clinical factors

Introduction: Implantable cardioverter-defibrillators (ICD) in patients exposed to the risk of lethal malignant ventricular arrhythmia proved to be the most effective method for preventing sudden cardiac death. The remaining problem is the tolerance of painful ICD discharges and patients’ quality of life (QOL). The results of the study on quality of life after implantation of an ICD were unequivocal. The aim of the research presented in this paper was to verify some discrepancies, in particular in the area of relationships between QOL and clinical factors. Material and methods: Eighty ICD patients were included in the research. The following tools were used in the assessment of QOL: the questionnaire by Kochańska, and the American questionnaire FPAS (Polish adaptation: Kochańska). Results: A negative correlation of ICD shocks with QOL was proven. This applies in particular to multiple inappropriate and recently experienced discharges. The incidence of complications related to the ICD as well as the experience of additional invasive procedures correlated negatively with QOL. The period of life spent with an ICD also proved to be significant. The lowest QOL was observed in patients who were 1-2 years after the procedure, and the highest among those who were at least 5 years after the procedure. Conclusions: Implantable cardioverter-defibrillators discharges reduce QOL and this pertains in particular to multiple and inappropriate shocks. Patients with an ICD who underwent additional procedures and invasive examinations, who experienced losses of consciousness after ICD implantation and those who had complications related to the ICD are at increased risk of reduced QOL. When interpreting the results of the research into QOL it is necessary to take into account the period of time since the first ICD implantation.