Determinants of the quality of life (QoL) in patients with an implantable cardioverter/defibrillator (ICD)

Objectives: In high-risk cardiac patients the treatment of life-threatening arrhythmias with an implantable cardioverter/defibrillator (ICD) extends survival. Other important outcome criteria are treatment side effects especially the quality of life (QoL). Knowledge of the variables that influence QoL is important for therapy decisions in ICD patients. Methods: Ninety-three ICD patients evaluated their QoL by the SF-36 after 1 - 6 years of ICD implantation. The QoL was studied in relation to cardiac function ( severity of heart failure, ejection fraction), treatment course ( number of shocks), coping styles and psychiatric syndromes. Results: About 30% of the somatic QoL ( physical role function, pain) is determined by the patients' somatization tendency, i.e. the extent to which they suffer from non-specific symptoms ( sweating, weakness in the legs, nausea). The severity of heart failure had little influence on the physical QoL. The emotional QoL is primarily determined by phobic anxiety of ICD patients. Conclusions: Psychiatric symptoms are the most important factors to determine the QoL in ICD patients. Behavioural treatment procedures of phobic anxieties and somatization could improve QoL in ICD patients.