Quality of life, depression, and anxiety in patients with a subcutaneous versus transvenous defibrillator system

Pacing Clin Electrophysiol. 2019 Dec;42(12):1541-1551. doi: 10.1111/pace.13828. Epub 2019 Nov 17.

Abstract

Background: Use of the subcutaneous implantable defibrillator (S-ICD) has increased because the device received US Food and Drug Administration approval in 2012, but we still know little about whether the quality of life (QoL) of patients with an S-ICD versus a transvenous ICD (TV-ICD) is comparable. We compared S-ICD patients with TV-ICD patients on QoL, depression, and anxiety up to 12 months' follow-up.

Methods: A matched cohort of S-ICD (N = 167) and TV-ICD patients (N = 167) completed measures on QoL, depression, anxiety, and personality at baseline, 3, 6, and 12 months post implant. Data were analyzed using multivariable modeling with repeated measures.

Results: In adjusted analyses, we found no statistically significant differences between cohorts on physical and mental QoL and depression (all Ps > .05), while S-ICD patients reported lower anxiety than TV-ICD patients (P = 0.0007). Both cohorts experienced improvements in physical and mental QoL and symptoms of depression and anxiety over time (all Ps < .001), primarily between implant and 3 months. These improvements were similar for both cohorts with respect to physical and mental QoL and anxiety (Ps > .05), while S-ICD patients experienced greater reductions in depressive symptoms (P = .0317).

Conclusion: The QoL and depression levels were similar in patients with an S-ICD and a TV-ICD up to 12 months' follow-up, while S-ICD patients reported lower anxiety levels and a greater reduction in depression over time as compared to TV-ICD patients. This knowledge may be important for patients and clinicians, if the indication for implantation allows both the S-ICD and the TV-ICD, making a choice possible.

Keywords: anxiety; depression; implantable cardioverter defibrillator; quality of life.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Anxiety / psychology*
  • Case-Control Studies
  • Defibrillators, Implantable / psychology*
  • Depression / psychology*
  • Equipment Design
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Surveys and Questionnaires