An implanted heart defibrillator is a life changer in more ways than one. More than one in 10 patients who receive the device also developed anxiety or depression, a new study reveals.
The findings highlight the need for regular screening of patients who receive an implantable cardioverter defibrillator (ICD) in order to identity those who may require additional mental health support, according to the authors of the study.
The research was presented Saturday at an online meeting of the European Society of Cardiology.
"Most patients adapt well to living with an ICD. For others, it completely changes their life, with worries about shocks from the device, body image, and livelihood as some need to change their job," said study author Susanne Pedersen, of Odense University Hospital in Denmark.
Previous research has shown that anxious or depressed ICD patients have poorer quality of life and increased risks of heart rhythm disorders and early death.
This study included more than 1,000 patients who completed questionnaires on their mental health and physical quality of life before and over 24 months after ICD implantation.
Over the follow-up period, nearly 15% of patients reported new-onset anxiety and about 11% reported new-onset depression.
Older age was associated with a lower risk of new-onset anxiety, while being married, type D personality, and lower self-reported physical functioning were associated with an increased risk. (Type Ds tend to be distressed).
Older age and higher self-reported physical functioning were associated with a lower risk of new-onset depression, while smoking, type D personality and lower self-reported physical functioning were associated with an increased risk, the findings showed.
"Our results suggest that more regular screening for depression and anxiety could identify patients who might benefit from additional support," Pedersen said in a society news release.
"Taken together, our findings indicate that younger patients, those with poor physical function, and those with type D personality are more likely to become anxious or depressed," she added. "People with type D personality tend to worry while not sharing negative emotions with others, which may compromise their mental health."
Pedersen noted that ICD implantation is often an outpatient procedure. While some patients are eager to return home, others become anxious and feel it's too soon because they haven't had time to adjust to having the implanted device.
"One way to remedy this could be digital support, using an app or platform to provide information and reassurance, enabling patients to talk to a health professional if needed, and referring those with high anxiety or depression scores to a psychologist for an online treatment program," Pedersen said.
"We are piloting this approach, and in my experience, it is a minority of patients who need it, but for those who do, it can mean a world of difference," she added.
Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.
The American Heart Association has more on ICDs.
SOURCE: European Society of Cardiology, news release, April 24, 2021