Skip to main content
Erschienen in: Current Cardiology Reports 9/2023

24.07.2023 | Psychological Aspects of Cardiovascular Diseases (IM Kronish, Section Editor)

Addressing PTSD in Implantable Cardioverter Defibrillator Patients: State-of-the-Art Management of ICD Shock and PTSD

verfasst von: Sears S. F., Harrell R., Sorrell A., Jordan E., Anthony S., Hashmath Z., Nekkanti R.

Erschienen in: Current Cardiology Reports | Ausgabe 9/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

This paper reviews the unique processes and treatments of post-traumatic stress in implantable cardioverter-defibrillator (ICD) patients and posits specific clinical management recommendations.

Recent Findings

PTSD is a common presenting problem for a prospective ICD patient and is a common response to ICD shocks. Approximately 32% of patients with sudden cardiac arrest report significant PTSD symptoms. Following ICD shock, approximately 20% experience PTSD from the shocks. Regardless, PTSD can interrupt and undermine clinical management from a cardiologist perspective and create significant disturbance in patients and families. Few cardiology clinics are outfitted to effectively manage psychological distress, in general, and PTSD, in particular.

Summary

Effective management of PTSD patients can be achieved with both direct care in the cardiac clinic, as well as indirect care via multidisciplinary consultation and expertise. The importance of emotional validation, return to physical activity, and family engagement is emphasized in current management.
Literatur
2.
Zurück zum Zitat •• Januszkiewicz Ł, Barra S, Providencia R, et al. Long-term quality of life and acceptance of implantable cardioverter-defibrillator therapy: results of the European Heart Rhythm Association survey. Europace. 2022;24(5):860–7. https://doi.org/10.1093/europace/euac011. This recent large-scale European survey of ICD patients provides contemporary patient views of their experiences in living with an ICD.CrossRefPubMed •• Januszkiewicz Ł, Barra S, Providencia R, et al. Long-term quality of life and acceptance of implantable cardioverter-defibrillator therapy: results of the European Heart Rhythm Association survey. Europace. 2022;24(5):860–7. https://​doi.​org/​10.​1093/​europace/​euac011. This recent large-scale European survey of ICD patients provides contemporary patient views of their experiences in living with an ICD.CrossRefPubMed
3.
Zurück zum Zitat Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018;15(10):e73–189. https://doi.org/10.1016/j.hrthm.2017.10.036.CrossRefPubMed Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2018;15(10):e73–189. https://​doi.​org/​10.​1016/​j.​hrthm.​2017.​10.​036.CrossRefPubMed
11.
Zurück zum Zitat Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing; 2022. Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Association Publishing; 2022.
14.
Zurück zum Zitat Miranda J, Stiles M, Lever N, Mahadevan H. Prevalence of depression and anxiety among patients with cardiac implantable electronic device (CIED). Heart Lung Circ. 2018;27:S13–4.CrossRef Miranda J, Stiles M, Lever N, Mahadevan H. Prevalence of depression and anxiety among patients with cardiac implantable electronic device (CIED). Heart Lung Circ. 2018;27:S13–4.CrossRef
16.
Zurück zum Zitat • Storer B, Kershaw KA, Braund TA, et al. Global prevalence of anxiety in adult cardiology outpatients: a systematic review and meta-analysis. Curr Probl Cardiol. 2023;101877. https://doi.org/10.1016/j.cpcardiol.2023.101877. This recent review provides a recent summation regarding the overall base rates of psychological distress across subgroups of cardiac patients. • Storer B, Kershaw KA, Braund TA, et al. Global prevalence of anxiety in adult cardiology outpatients: a systematic review and meta-analysis. Curr Probl Cardiol. 2023;101877. https://​doi.​org/​10.​1016/​j.​cpcardiol.​2023.​101877. This recent review provides a recent summation regarding the overall base rates of psychological distress across subgroups of cardiac patients.
18.
Zurück zum Zitat •• Ghezzi ES, Sharman RLS, Selvanayagam JB, et al. Burden of mood symptoms and disorders in implantable cardioverter defibrillator patients: a systematic review and meta-analysis of 39 954 patients. Europace. 2023;25(6):euad130. https://doi.org/10.1093/europace/euad130. This recent meta-analysis provides the most comprehensive review of literature related to base rates of psychological distress in ICD patients. •• Ghezzi ES, Sharman RLS, Selvanayagam JB, et al. Burden of mood symptoms and disorders in implantable cardioverter defibrillator patients: a systematic review and meta-analysis of 39 954 patients. Europace. 2023;25(6):euad130. https://​doi.​org/​10.​1093/​europace/​euad130. This recent meta-analysis provides the most comprehensive review of literature related to base rates of psychological distress in ICD patients.
22.
Zurück zum Zitat • Sears SF, Rosman L, Sasaki S, et al. Defibrillator shocks and their effect on objective and subjective patient outcomes: results of the PainFree SST clinical trial. Heart Rhythm. 2018;15(5):734–40. https://doi.org/10.1016/j.hrthm.2017.12.026. This paper demonstrates the longitudinal impact of ICD shocks on patient activity levels and shock anxiety in a large international clinical trial.CrossRefPubMed • Sears SF, Rosman L, Sasaki S, et al. Defibrillator shocks and their effect on objective and subjective patient outcomes: results of the PainFree SST clinical trial. Heart Rhythm. 2018;15(5):734–40. https://​doi.​org/​10.​1016/​j.​hrthm.​2017.​12.​026. This paper demonstrates the longitudinal impact of ICD shocks on patient activity levels and shock anxiety in a large international clinical trial.CrossRefPubMed
24.
Zurück zum Zitat •• Lindekilde N, Skov O, Skovbakke SJ, Johansen JB, Nielsen JC, Pedersen SS. Anxiety and depression as risk factors for ICD shocks and mortality in patients with an implantable cardioverter defibrillator - a systematic review. Gen Hosp Psychiatry. 2022;78:96–107. https://doi.org/10.1016/j.genhosppsych.2022.07.008. The recent review highlights the lack of evidence for psychological distress as a trigger for ICD shocks. Relationships between distress and mortality are established however.CrossRefPubMed •• Lindekilde N, Skov O, Skovbakke SJ, Johansen JB, Nielsen JC, Pedersen SS. Anxiety and depression as risk factors for ICD shocks and mortality in patients with an implantable cardioverter defibrillator - a systematic review. Gen Hosp Psychiatry. 2022;78:96–107. https://​doi.​org/​10.​1016/​j.​genhosppsych.​2022.​07.​008. The recent review highlights the lack of evidence for psychological distress as a trigger for ICD shocks. Relationships between distress and mortality are established however.CrossRefPubMed
25.
Zurück zum Zitat Ladwig KH, Baumert J, Marten-Mittag B, Kolb C, Zrenner B, Schmitt C. Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study. Arch Gen Psychiatry. 2008;65(11):1324–30. https://doi.org/10.1001/archpsyc.65.11.1324.CrossRefPubMed Ladwig KH, Baumert J, Marten-Mittag B, Kolb C, Zrenner B, Schmitt C. Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study. Arch Gen Psychiatry. 2008;65(11):1324–30. https://​doi.​org/​10.​1001/​archpsyc.​65.​11.​1324.CrossRefPubMed
37.
Zurück zum Zitat Lee KS, Kim JH, Kang KW, Miller J, McEvedy SM, Hwang SY, Moser DK. Implantable cardioverter defibrillator shocks and psychological distress: examining the mediating roles of implantable cardioverter defibrillator–related concerns and perceived control. J Cardiovasc Nurs 2020;35(1):66–73. https://doi.org/10.1097/JCN.0000000000000610. Lee KS, Kim JH, Kang KW, Miller J, McEvedy SM, Hwang SY, Moser DK. Implantable cardioverter defibrillator shocks and psychological distress: examining the mediating roles of implantable cardioverter defibrillator–related concerns and perceived control. J Cardiovasc Nurs 2020;35(1):66–73.  https://​doi.​org/​10.​1097/​JCN.​0000000000000610​.
41.
Zurück zum Zitat Prudente LA. Phantom shock in a patient with an implantable cardioverter defibrillator: case report. Am J Crit Care. 2003;12(2):144–6.CrossRefPubMed Prudente LA. Phantom shock in a patient with an implantable cardioverter defibrillator: case report. Am J Crit Care. 2003;12(2):144–6.CrossRefPubMed
43.
Zurück zum Zitat Groh WJ, Foreman LD, Zipes DP. Advances in the treatment of arrhythmias: implantable cardioverter-defibrillators. Am Fam Physician. 1998;57(2):297–312.PubMed Groh WJ, Foreman LD, Zipes DP. Advances in the treatment of arrhythmias: implantable cardioverter-defibrillators. Am Fam Physician. 1998;57(2):297–312.PubMed
45.
Zurück zum Zitat Varghese S, Geller JC, Ohlow MA. Phantom shocks in implantable cardioverter-defibrillator recipients: impact of education level, anxiety, and depression. Phantomschocks bei Patienten mit implantierbarem Kardioverter-Defibrillator: Einfluss von Bildungsniveau, Angst und Depression. Herzschrittmacherther Elektrophysiol. 2019;30(3):306–12. https://doi.org/10.1007/s00399-019-00645-y. Varghese S, Geller JC, Ohlow MA. Phantom shocks in implantable cardioverter-defibrillator recipients: impact of education level, anxiety, and depression. Phantomschocks bei Patienten mit implantierbarem Kardioverter-Defibrillator: Einfluss von Bildungsniveau, Angst und Depression. Herzschrittmacherther Elektrophysiol. 2019;30(3):306–12. https://​doi.​org/​10.​1007/​s00399-019-00645-y.
53.
Zurück zum Zitat Berg SK, Rasmussen TB, Herning M, Svendsen JH, Christensen AV, Thygesen LC. Cognitive behavioural therapy significantly reduces anxiety in patients with implanted cardioverter defibrillator compared with usual care: Findings from the Screen-ICD randomised controlled trial. Eur J Prev Cardiol. 2020;27(3):258–68. https://doi.org/10.1177/2047487319874147.CrossRefPubMed Berg SK, Rasmussen TB, Herning M, Svendsen JH, Christensen AV, Thygesen LC. Cognitive behavioural therapy significantly reduces anxiety in patients with implanted cardioverter defibrillator compared with usual care: Findings from the Screen-ICD randomised controlled trial. Eur J Prev Cardiol. 2020;27(3):258–68. https://​doi.​org/​10.​1177/​2047487319874147​.CrossRefPubMed
74.
Zurück zum Zitat Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: the process and practice of mindful change. The Guilford Press; 2016. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: the process and practice of mindful change. The Guilford Press; 2016.
76.
Zurück zum Zitat Rashidi A, Whitehead L, Newson L, et al. The role of acceptance and commitment therapy in cardiovascular and diabetes healthcare: a scoping review. Int J Environ Res Public Health. 2021;18(15):8126. Published 2021 Jul 31. https://doi.org/10.3390/ijerph18158126. Rashidi A, Whitehead L, Newson L, et al. The role of acceptance and commitment therapy in cardiovascular and diabetes healthcare: a scoping review. Int J Environ Res Public Health. 2021;18(15):8126. Published 2021 Jul 31. https://​doi.​org/​10.​3390/​ijerph18158126.
79.
Zurück zum Zitat • Dougherty CM, Thompson EA, Kudenchuk PJ. Patient plus partner trial: a randomized controlled trial of 2 interventions to improve outcomes after an initial implantable cardioverter-defibrillator. Heart Rhythm. 2019;16(3):453–9. https://doi.org/10.1016/j.hrthm.2018.10.011. This trial provides evidence of the importance of family and caregivers in the care of ICD patients.CrossRefPubMed • Dougherty CM, Thompson EA, Kudenchuk PJ. Patient plus partner trial: a randomized controlled trial of 2 interventions to improve outcomes after an initial implantable cardioverter-defibrillator. Heart Rhythm. 2019;16(3):453–9. https://​doi.​org/​10.​1016/​j.​hrthm.​2018.​10.​011. This trial provides evidence of the importance of family and caregivers in the care of ICD patients.CrossRefPubMed
Metadaten
Titel
Addressing PTSD in Implantable Cardioverter Defibrillator Patients: State-of-the-Art Management of ICD Shock and PTSD
verfasst von
Sears S. F.
Harrell R.
Sorrell A.
Jordan E.
Anthony S.
Hashmath Z.
Nekkanti R.
Publikationsdatum
24.07.2023
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 9/2023
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-01924-4

Weitere Artikel der Ausgabe 9/2023

Current Cardiology Reports 9/2023 Zur Ausgabe

New Therapies for Cardiovascular Disease (AA Bavry and M Massoomi, Section Editors)

Efficacy of Bioactive Compounds in the Regulation of Metabolism and Pathophysiology in Cardiovascular Diseases

Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

Venous Ethanol Ablation Approaches for Radiofrequency-Refractory Cardiac Arrhythmias

Lipid Abnormalities and Cardiovascular Prevention (ED Michos, Section Editor)

Pleiotropy of PCSK9: Functions in Extrahepatic Tissues

Congenital Heart Disease (RA Krasuski and G Fleming, Section Editors)

Update on Transcatheter Device Closure of Congenital Septal Defects

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.