Age, Sex, and Remote Monitoring Differences in Device Acceptance for Patients With Implanted Cardioverter Defibrillators in Canada

Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device recipients. Previous findings have indicated that younger patients experience poorer device adjustment. The purpose of this study was to examine...

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Published inCJC open (Online) Vol. 2; no. 6; pp. 483 - 489
Main Authors Ng, Jessica, Sears, Samuel F., Exner, Derek V., Reyes, Lucy, Cravetchi, Xenia, Cassidy, Peggy, Morton, James, Lohrenz, Carmen, Low, Aaron, Sandhu, Roopinder K., Sheldon, Robert S., Raj, Satish R.
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LanguageEnglish
Published United States Elsevier Inc 01.11.2020
Elsevier
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Abstract Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device recipients. Previous findings have indicated that younger patients experience poorer device adjustment. The purpose of this study was to examine age and ICD-specific quality-of-life outcomes in a large sample of Canadian ICD patients. We tested the hypothesis that patient age is related to device acceptance and shock anxiety in an Alberta (Canada) ICD population. The Florida Patient Acceptance Survey (FPAS) and Florida Shock Acceptance Survey (FSAS) were completed by ICD patients attending the Cardiac Implantable Electrical Device Clinics in Alberta. The population was dichotomized into those aged ≤ 65 years (younger) and those aged > 65 years (older). Sex, ICD shock history, and remote monitoring use were also examined. Surveys were completed by 126 younger (53 ± 11 years; 79% male) and 216 older (74 ± 6 years; 85% male) patients. Younger, compared with older, patients had greater device-related distress (P < 0.001) and more body-image concerns (P < 0.001), but no differences in return to function or positive appraisal. Younger patients reported lower total device acceptance (P = 0.001) and greater total shock anxiety (P < 0.001) compared with older patients. ICD patients aged ≤ 65 years reported poorer device acceptance and greater shock anxiety than older patients. Younger patients may require targeted interventions addressing adjustment to the ICD, and impact of the ICD on body image. Moreover, education about the relatively low probability of shocks may alleviate shock anxiety in younger patients. L’acceptation d’un défibrillateur cardioverteur implantable (DCI) et la crainte des chocs de DCI sont des problèmes auxquels les cliniciens devraient s’attaquer pour améliorer la qualité de vie des patients qui sont porteurs d’un DCI. Selon des observations antérieures, les plus jeunes patients ont davantage de mal à s’adapter au dispositif. L’étude avait pour objet l’examen des paramètres de la qualité de vie particuliers à l’âge et au port d’un DCI dans un vaste échantillon de patients canadiens porteurs de ce dispositif. Nous avons testé l’hypothèse voulant que l’âge du patient soit lié à l’acceptation du dispositif et à la crainte des chocs chez des Albertains porteurs d’un DCI. Les patients des cliniques de l'Alberta (Canada) des dispositifs cardiaques électroniques implantables qui étaient porteurs d’un DCI ont rempli les questionnaires FPAS (Florida Patient Acceptance Survey) et FSAS (Florida Shock Acceptance Survey). Les patients ont été partagés en deux groupes selon leur âge, soit ceux de 65 ans et moins (plus jeunes patients) et ceux de plus de 65 ans (patients âgés). Nous avons aussi examiné les facteurs suivants : sexe, chocs de DCI antérieurs et utilisation d’une télésurveillance. Les questionnaires ont été remplis par 126 plus jeunes patients (53 ± 11 ans; 79 % d’hommes) et 216 patients âgés (74 ± 6 ans; 85 % d’hommes). Chez les plus jeunes patients, par rapport aux patients âgés, la détresse causée par le dispositif était plus grande (p < 0,001) et il y avait davantage de préoccupations liées à l’image corporelle (p < 0001), mais il n’y avait pas de différences pour ce qui est de la reprise des activités ou de l’évaluation positive du dispositif. Chez les plus jeunes patients, l’acceptation totale du dispositif était moindre (p = 0,001) et la crainte des chocs était plus grande (p < 0,001) que chez les patients âgés. Chez les porteurs d’un DCI de 65 ans et moins, le dispositif était moins bien accepté, et la crainte des chocs était plus grande que chez les patients âgés. Chez les plus jeunes patients, des interventions ciblées axées sur l’adaptation au DCI et les répercussions du DCI sur l’image corporelle pourraient être nécessaires. De plus, l’éducation à propos de la probabilité relativement faible de subir des chocs pourrait réduire cette crainte chez les plus jeunes patients.
AbstractList Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device recipients. Previous findings have indicated that younger patients experience poorer device adjustment. The purpose of this study was to examine age and ICD-specific quality-of-life outcomes in a large sample of Canadian ICD patients. We tested the hypothesis that patient age is related to device acceptance and shock anxiety in an Alberta (Canada) ICD population. The Florida Patient Acceptance Survey (FPAS) and Florida Shock Acceptance Survey (FSAS) were completed by ICD patients attending the Cardiac Implantable Electrical Device Clinics in Alberta. The population was dichotomized into those aged ≤ 65 years (younger) and those aged > 65 years (older). Sex, ICD shock history, and remote monitoring use were also examined. Surveys were completed by 126 younger (53 ± 11 years; 79% male) and 216 older (74 ± 6 years; 85% male) patients. Younger, compared with older, patients had greater device-related distress (P < 0.001) and more body-image concerns (P < 0.001), but no differences in return to function or positive appraisal. Younger patients reported lower total device acceptance (P = 0.001) and greater total shock anxiety (P < 0.001) compared with older patients. ICD patients aged ≤ 65 years reported poorer device acceptance and greater shock anxiety than older patients. Younger patients may require targeted interventions addressing adjustment to the ICD, and impact of the ICD on body image. Moreover, education about the relatively low probability of shocks may alleviate shock anxiety in younger patients. L’acceptation d’un défibrillateur cardioverteur implantable (DCI) et la crainte des chocs de DCI sont des problèmes auxquels les cliniciens devraient s’attaquer pour améliorer la qualité de vie des patients qui sont porteurs d’un DCI. Selon des observations antérieures, les plus jeunes patients ont davantage de mal à s’adapter au dispositif. L’étude avait pour objet l’examen des paramètres de la qualité de vie particuliers à l’âge et au port d’un DCI dans un vaste échantillon de patients canadiens porteurs de ce dispositif. Nous avons testé l’hypothèse voulant que l’âge du patient soit lié à l’acceptation du dispositif et à la crainte des chocs chez des Albertains porteurs d’un DCI. Les patients des cliniques de l'Alberta (Canada) des dispositifs cardiaques électroniques implantables qui étaient porteurs d’un DCI ont rempli les questionnaires FPAS (Florida Patient Acceptance Survey) et FSAS (Florida Shock Acceptance Survey). Les patients ont été partagés en deux groupes selon leur âge, soit ceux de 65 ans et moins (plus jeunes patients) et ceux de plus de 65 ans (patients âgés). Nous avons aussi examiné les facteurs suivants : sexe, chocs de DCI antérieurs et utilisation d’une télésurveillance. Les questionnaires ont été remplis par 126 plus jeunes patients (53 ± 11 ans; 79 % d’hommes) et 216 patients âgés (74 ± 6 ans; 85 % d’hommes). Chez les plus jeunes patients, par rapport aux patients âgés, la détresse causée par le dispositif était plus grande (p < 0,001) et il y avait davantage de préoccupations liées à l’image corporelle (p < 0001), mais il n’y avait pas de différences pour ce qui est de la reprise des activités ou de l’évaluation positive du dispositif. Chez les plus jeunes patients, l’acceptation totale du dispositif était moindre (p = 0,001) et la crainte des chocs était plus grande (p < 0,001) que chez les patients âgés. Chez les porteurs d’un DCI de 65 ans et moins, le dispositif était moins bien accepté, et la crainte des chocs était plus grande que chez les patients âgés. Chez les plus jeunes patients, des interventions ciblées axées sur l’adaptation au DCI et les répercussions du DCI sur l’image corporelle pourraient être nécessaires. De plus, l’éducation à propos de la probabilité relativement faible de subir des chocs pourrait réduire cette crainte chez les plus jeunes patients.
BACKGROUNDImplantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device recipients. Previous findings have indicated that younger patients experience poorer device adjustment. The purpose of this study was to examine age and ICD-specific quality-of-life outcomes in a large sample of Canadian ICD patients. We tested the hypothesis that patient age is related to device acceptance and shock anxiety in an Alberta (Canada) ICD population. METHODSThe Florida Patient Acceptance Survey (FPAS) and Florida Shock Acceptance Survey (FSAS) were completed by ICD patients attending the Cardiac Implantable Electrical Device Clinics in Alberta. The population was dichotomized into those aged ≤ 65 years (younger) and those aged > 65 years (older). Sex, ICD shock history, and remote monitoring use were also examined. RESULTSSurveys were completed by 126 younger (53 ± 11 years; 79% male) and 216 older (74 ± 6 years; 85% male) patients. Younger, compared with older, patients had greater device-related distress (P < 0.001) and more body-image concerns (P < 0.001), but no differences in return to function or positive appraisal. Younger patients reported lower total device acceptance (P = 0.001) and greater total shock anxiety (P < 0.001) compared with older patients. CONCLUSIONSICD patients aged ≤ 65 years reported poorer device acceptance and greater shock anxiety than older patients. Younger patients may require targeted interventions addressing adjustment to the ICD, and impact of the ICD on body image. Moreover, education about the relatively low probability of shocks may alleviate shock anxiety in younger patients.
Background: Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device recipients. Previous findings have indicated that younger patients experience poorer device adjustment. The purpose of this study was to examine age and ICD-specific quality-of-life outcomes in a large sample of Canadian ICD patients. We tested the hypothesis that patient age is related to device acceptance and shock anxiety in an Alberta (Canada) ICD population. Methods: The Florida Patient Acceptance Survey (FPAS) and Florida Shock Acceptance Survey (FSAS) were completed by ICD patients attending the Cardiac Implantable Electrical Device Clinics in Alberta. The population was dichotomized into those aged ≤ 65 years (younger) and those aged > 65 years (older). Sex, ICD shock history, and remote monitoring use were also examined. Results: Surveys were completed by 126 younger (53 ± 11 years; 79% male) and 216 older (74 ± 6 years; 85% male) patients. Younger, compared with older, patients had greater device-related distress (P < 0.001) and more body-image concerns (P < 0.001), but no differences in return to function or positive appraisal. Younger patients reported lower total device acceptance (P = 0.001) and greater total shock anxiety (P < 0.001) compared with older patients. Conclusions: ICD patients aged ≤ 65 years reported poorer device acceptance and greater shock anxiety than older patients. Younger patients may require targeted interventions addressing adjustment to the ICD, and impact of the ICD on body image. Moreover, education about the relatively low probability of shocks may alleviate shock anxiety in younger patients. Résumé: Contexte: L’acceptation d’un défibrillateur cardioverteur implantable (DCI) et la crainte des chocs de DCI sont des problèmes auxquels les cliniciens devraient s’attaquer pour améliorer la qualité de vie des patients qui sont porteurs d’un DCI. Selon des observations antérieures, les plus jeunes patients ont davantage de mal à s’adapter au dispositif. L’étude avait pour objet l’examen des paramètres de la qualité de vie particuliers à l’âge et au port d’un DCI dans un vaste échantillon de patients canadiens porteurs de ce dispositif. Nous avons testé l’hypothèse voulant que l’âge du patient soit lié à l’acceptation du dispositif et à la crainte des chocs chez des Albertains porteurs d’un DCI. Méthodologie: Les patients des cliniques de l'Alberta (Canada) des dispositifs cardiaques électroniques implantables qui étaient porteurs d’un DCI ont rempli les questionnaires FPAS (Florida Patient Acceptance Survey) et FSAS (Florida Shock Acceptance Survey). Les patients ont été partagés en deux groupes selon leur âge, soit ceux de 65 ans et moins (plus jeunes patients) et ceux de plus de 65 ans (patients âgés). Nous avons aussi examiné les facteurs suivants : sexe, chocs de DCI antérieurs et utilisation d’une télésurveillance. Résultats: Les questionnaires ont été remplis par 126 plus jeunes patients (53 ± 11 ans; 79 % d’hommes) et 216 patients âgés (74 ± 6 ans; 85 % d’hommes). Chez les plus jeunes patients, par rapport aux patients âgés, la détresse causée par le dispositif était plus grande (p < 0,001) et il y avait davantage de préoccupations liées à l’image corporelle (p < 0001), mais il n’y avait pas de différences pour ce qui est de la reprise des activités ou de l’évaluation positive du dispositif. Chez les plus jeunes patients, l’acceptation totale du dispositif était moindre (p = 0,001) et la crainte des chocs était plus grande (p < 0,001) que chez les patients âgés. Conclusions: Chez les porteurs d’un DCI de 65 ans et moins, le dispositif était moins bien accepté, et la crainte des chocs était plus grande que chez les patients âgés. Chez les plus jeunes patients, des interventions ciblées axées sur l’adaptation au DCI et les répercussions du DCI sur l’image corporelle pourraient être nécessaires. De plus, l’éducation à propos de la probabilité relativement faible de subir des chocs pourrait réduire cette crainte chez les plus jeunes patients.
Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device recipients. Previous findings have indicated that younger patients experience poorer device adjustment. The purpose of this study was to examine age and ICD-specific quality-of-life outcomes in a large sample of Canadian ICD patients. We tested the hypothesis that patient age is related to device acceptance and shock anxiety in an Alberta (Canada) ICD population. The Florida Patient Acceptance Survey (FPAS) and Florida Shock Acceptance Survey (FSAS) were completed by ICD patients attending the Cardiac Implantable Electrical Device Clinics in Alberta. The population was dichotomized into those aged ≤ 65 years (younger) and those aged > 65 years (older). Sex, ICD shock history, and remote monitoring use were also examined. Surveys were completed by 126 younger (53 ± 11 years; 79% male) and 216 older (74 ± 6 years; 85% male) patients. Younger, compared with older, patients had greater device-related distress ( < 0.001) and more body-image concerns ( < 0.001), but no differences in return to function or positive appraisal. Younger patients reported lower total device acceptance (  = 0.001) and greater total shock anxiety ( < 0.001) compared with older patients. ICD patients aged ≤ 65 years reported poorer device acceptance and greater shock anxiety than older patients. Younger patients may require targeted interventions addressing adjustment to the ICD, and impact of the ICD on body image. Moreover, education about the relatively low probability of shocks may alleviate shock anxiety in younger patients.
Author Reyes, Lucy
Morton, James
Raj, Satish R.
Cassidy, Peggy
Cravetchi, Xenia
Sheldon, Robert S.
Ng, Jessica
Lohrenz, Carmen
Exner, Derek V.
Low, Aaron
Sears, Samuel F.
Sandhu, Roopinder K.
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Snippet Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among device...
BACKGROUNDImplantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life among...
Background: Implantable cardioverter defibrillator (ICD) acceptance and shock anxiety are issues that clinicians should address to improve quality of life...
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Title Age, Sex, and Remote Monitoring Differences in Device Acceptance for Patients With Implanted Cardioverter Defibrillators in Canada
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