scholarly journals Anxiety and depression symptoms in Danish patients with an implantable cardioverter-defibrillator: prevalence and association with indication and sex up to 2 years of follow-up (data from the national DEFIB-WOMEN study)

EP Europace ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. 1830-1840
Author(s):  
Vivi Skibdal Frydensberg ◽  
Jens Brock Johansen ◽  
Sören Möller ◽  
Sam Riahi ◽  
Sonja Wehberg ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Time Points ◽  
Mixed Modelling

Abstract Aims To investigate (i) the prevalence of anxiety and depression and (ii) the association between indication for implantable cardioverter-defibrillator (ICD) implantation and sex in relation to anxiety and depression up to 24 months’ follow-up. Methods and results Patients with a first-time ICD, participating in the national, multi-centre, prospective DEFIB-WOMEN study (n = 1496; 18% women) completed the Hospital Anxiety and Depression Scale at baseline, 3, 6, 12, and 24 months. Data were analysed using linear mixed modelling for longitudinal data. Patients with a secondary prophylactic indication (SPI) had higher mean anxiety scores than patients with a primary prophylactic indication (PPI) at baseline, 3, and 12 months and higher mean depression scores at all-time points, except at 24 months. Women had higher mean anxiety scores as compared to men at all-time points; however, only higher mean depression scores at baseline. Overall, women with SPI had higher anxiety and depression symptom scores than men with SPI. Symptoms decreased over time in both women and men. From baseline to follow-up, the prevalence of anxiety (score ≥8) was highest in patients with SPI (13.3–20.2%) as compared to patients with PPI (range 10.0–14.7%). The prevalence of depression was stable over the follow-up period in both groups (range 8.5–11.1%). Conclusion Patients with a SPI reported higher anxiety and depression scores as compared to patients with PPI. Women reported higher anxiety scores than men, but only higher depression scores at baseline. Women with SPI reported the highest anxiety and depression scores overall.

scholarly journals Anxiety, depression and cardiac anxiety in patients with implantable cardioverter-defibrillator according to gender and age

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e61117
Author(s):  
Isabelle Brigliadori Ignácio ◽  
Paolla Algarte Fernandes ◽  
Suellen Rodrigues de Oliveira Maier ◽  
Carina Aparecida Marost Dessotte
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Statistical Significance ◽  
University Hospital ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cross Sectional ◽  
Cardioverter Defibrillator ◽  
Cardiac Anxiety ◽  
Gender And Age ◽  
Anxiety Depression

Objective: to investigate the relationship between gender and age with symptoms of anxiety, depression and cardiac anxiety in patients with implantable cardioverter-defibrillator. Methods: cross-sectional study, with 76 patients with device attended in a university hospital. For data collection, a sociodemographic/clinical form and two validated scales were used in Brazil. In the analysis, the chi-square tests, exact Fischer and Mann-Whitney, with a significance level of 5% were adopted. Results: it was observed that the groups were homogeneous in terms of gender and age. Women presented higher medians in both anxiety and depression symptoms, with statistical significance. They also presented higher medians in symptoms of cardiac anxiety, but without statistical significance. Regarding age, no significant differences were found for the symptoms investigated. Conclusion: women presented more symptoms of anxiety and depression; however there was no relationship between the age of the patients and their symptoms.

scholarly journals Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Zhi-wei Hou ◽  
Hai-bo Yu ◽  
Yan-chun Liang ◽  
Yang Gao ◽  
Guo-qing Xu ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Implantable Cardioverter Defibrillator ◽  
Severe Heart Failure ◽  
Icd Implantation ◽  
Soluble St2 ◽  
Cardioverter Defibrillator ◽  
Device Implantation ◽  
All Cause Mortality

Background. Heart failure (HF) is the terminal stage of all cardiovascular events. Although implantable cardioverter defibrillator (ICD) therapies have reduced mortality among the high-risk HF population, it is necessary to determine whether certain factors can predict mortality even after cardiac device implantation. Growth stimulation expressed gene 2 (ST2) is an emerging biomarker for HF patient stratification in different clinical settings. Aims. This study aimed to investigate the relationship between baseline soluble ST2 (sST2) levels in serum and the clinical outcomes of high-risk HF patients with device implantation. Methods. Between January 2017 and August 2018, we prospectively recruited consecutive patients implanted with an ICD for heart failure, with LVEF ≤35% as recommended, and analyzed the basic characteristics, baseline serum sST2, and NT-proBNP levels, with at least 1-year follow-up. All-cause mortality was the primary endpoint. Results. During a 643-day follow-up, all-cause mortality occurred in 16 of 150 patients (10.67%). Incidence of all-cause mortality increased significantly in patients with sST2 levels above 34.98846 ng/ml (16.00% vs. 5.33%, P = 0.034 ). After adjusting the model (age, gender, device implantation, prevention of sudden death, LVEDD, LVEF, WBC and CLBBB, hsTNT, etiology, and eGFR) and the model combined with NT-proBNP, the risk of all-cause death was increased by 2.5% and 1.9%, respectively, per ng/ml of sST2. The best sST2 cutoff for predicting all-cause death was 43.42671 ng/ml (area under the curve: 0.72, sensitive: 0.69, and specificity: 0.69). Compared to patients with sST2 levels below 43.42671 ng/ml, the risk of all-cause mortality was higher in those with values above the threshold (5.1% vs. 21.2%, P = 0.002 ). ST2 level ≥43.42671 ng/ml was an independent predictor of all-cause mortality (HR: 3.30 [95% CI 1.02–10.67]). Age (HR: 1.06 [95% CI: 1.01–1.12]) and increased NT-proBNP per 100 (HR: 1.02 [95% CI: 1.01–1.03]) were also associated with all-cause mortality in ICD patients. Conclusions. sST2 level was associated with risk of all-cause mortality, and a threshold of 43.43 ng/ml showed good distinguishing performance to predict all-cause mortality in patients with severe heart failure, recommended for ICD implantation. Patients with sST2 levels more than 43.42671 ng/ml even after ICD implantation should therefore be monitored carefully.

Abstract 16519: Meta-analysis of Outcome After Implantable Cardioverter Defibrillator Therapy in Patients With Cardiac Amyloidosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sisir Siddamsetti ◽  
Mojgan Golzy ◽  
Sandeep Gautam
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Cardiac Amyloidosis ◽  
Large Scale ◽  
Meta Analysis ◽  
Icd Implantation ◽  
Icd Therapy ◽  
Cardioverter Defibrillator ◽  
All Cause Mortality ◽  
Appropriate Therapy

Introduction: Cardiac amyloidosis is associated with high risk for sudden cardiac death. However, the potential benefit of implantable cardioverter defibrillator (ICD) implantation in CA is unknown due to limited available data regarding outcomes following ICD implantation in this patient population. We sought to perform a meta-analysis of trials that evaluated the outcomes of ICD implantation in CA. Methods: We performed a systematic literature review in PubMed, SCOPUS, and Cochrane to identify all studies that evaluated ICD therapy in CA until May 2020. Outcomes analyzed were all-cause mortality and appropriate ICD therapy rates. A random effects model was used to calculate percentages and 95% confidence intervals (CI) of outcomes. Results: Of the screened articles, 5 observational studies were included for analysis. A total of 151 patients were analyzed. Mean age of population was 61.6 +/- 0.7 years and 79.2% were male. The all-cause mortality rate was 33% (95% CI:16 to 51%) and the incidence of appropriate ICD therapy was 23% (95% CI:16 to 30%) over a mean follow up period of 16 months (Figure). In trials that evaluated ICD therapy in non-ischemic cardiomyopathy such as DANISH, DEFINITE and SCD-HeFT trials mortality rates in the ICD arm were 21.6 % over 67.6 months, 9.4% over 29 months and 16.7% over 45.5 months, respectively. The incidence of appropriate therapy in DANISH, DEFINITE and SCD-HeFT trials were 28.9%, 19.8 % and 21% respectively. Conclusions: CA patients with ICD have equivalent appropriate therapy with disproportionately higher mortality over a shorter follow up compared to randomized trials of primary prevention ICD placement in NICMP. The benefit of ICD placement for mortality reduction in CA remains unclear and further large-scale studies are required to address this issue.

Is it chicken or the egg: Obesity, anxiety and depression in hospital workers

2021 ◽  
pp. 1-11
Author(s):  
Sema Akkaya Demir ◽  
Rana Nagihan Akder ◽  
Reci Meseri
Keyword(s):  
Abdominal Obesity ◽  
Depression Scale ◽  
Severe Depression ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
P Value ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Independent Factor ◽  
Cross Sectional

BACKGROUND: Healthcare workers are susceptible to obesity, anxiety and depression. OBJECTIVE: To determine the prevalence and association of obesity, anxiety and depression symptoms in individuals working in a hospital. METHODS: In this cross-sectional study all of the employees of a hospital were invited to participate (n = 150). Anxiety (via Beck Anxiety Scale) and depression symptoms (via Beck Depression Scale) and obesity were dependent and independent variables. Obesity was determined both with body mass index (BMI) and abdominal obesity (Waist circumference-WC). Data were collected with face-to-face interviews and anthropometric measurements were done. Data were analyzed using SPSS version 25.0 with student t-test, chi-square and correlation tests. Significance was set at a p-value <  0.05. RESULTS: Among the participants who agreed to participate (n = 131, 64.1% females), 35.1% were obese and 50.4% were abdominally obese. The 35.9% had moderate-severe anxiety symptoms, 19.1% had moderate-severe depression symptoms. Both BMI and WC had positive, moderate and significant correlation with anxiety and depression scores. After adjusting for socio-demographic variables obesity (both with BMI and WC) was an independent factor for anxiety and depression symptom presence, whereas after adjusted for these variables anxiety and depression symptom presence was an independent factor for obesity and abdominal obesity (p = 0.001 for all). CONCLUSIONS: There is a correlation between anxiety, depression and obesity. In addition to nutrition interventions in combating obesity, services that will improve mental health should be provided together as teamwork.

Cardioverter-related complications: observations from an institutional implantable cardioverter defibrillator registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
I Prepolec ◽  
V Pasara ◽  
E Ciglenecki ◽  
J Putric Posavec ◽  
JE Bogdanic ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Implantable Cardioverter Defibrillator ◽  
Needle Aspiration ◽  
Left Ventricular ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Vein Thrombosis ◽  
Funding Sources ◽  
Major Complications

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Implantable cardioverter defibrillator (ICD) is gold standard therapy for primary and secondary prevention of sudden cardiac death (SCD) and ventricular tachyarrhythmias. While reducing arrhythmic mortality in patients with left ventricular dysfunction of various causes, inherited primary arrhythmia syndromes and after aborted SCD, these devices can have serious adverse effects including inappropriate shocks and device-related infection. Purpose The aim of this study was to create an institutional ICD registry and to examine the major complications after ICD implantation. Methods We analysed the data concerning all newly implanted ICDs in our institution from 2011 to 2017. All patients received periprocedural antibiotic prophylaxis according to relevant guidelines. Follow-up data was collected from hospital electronic medical records. Results Total number of implanted ICDs was 507 (85.4% male, 57.6 ± 14.0 years-old) and mean follow-up was 34.3 ± 23.8 months. Major complications (infection, large haematoma/hemorrhage, lead displacement/dysfunction) occurred in 18 (3.6%) patients. In 9 (1.8%) cases patients were diagnosed with ICD infection (8 surgical wound/pocket infections and 1 confirmed endocarditis of the lead). Device was explanted in 5 cases (1.0%) while the rest were treated only with antibiotic therapy (empirically or according to swab/blood culture results). All of the infections were successfully resolved and no relapses were noted. Eventually, 3 of 5 devices were reimplanted. One death was recorded 5 month after the explanation. Second most common complication was lead displacement/dysfunction which occurred in 5 (1.0%) patients and was successfully repaired in all cases. Large haematoma and/or hemorrhage at the implantation site were present in 5 (0.8%) patients (2 required surgical revision and transfusion while 2 were managed by needle aspiration). Pneumothorax (2 cases, 0.4%) had to be drained in one patient. There was one case of subclavian vein thrombosis which was treated by anticoagulation. Conclusion Despite appropriate antibiotic prophylaxis, the rate of ICD infections in our institution was relatively higher than the one reported in similar registries. The prevalence of other major complications, including lead dysfunction was quite low. Institutional registries could help monitor and plan actions to resolve ICD-related complications to improve patient outcomes.

Abstract 20158: Long-Term Device-Related Adverse Events After Implantable Cardioverter-Defibrillator Therapy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Isuru Ranasinghe ◽  
Craig Parzynski ◽  
James V Freeman ◽  
Rachel P Dreyer ◽  
Joseph S Ross ◽  
...  
Keyword(s):  
Adverse Events ◽  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Adverse Outcomes ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Risk Of Death ◽  
Device Malfunction

Background: Long-term implantable cardioverter-defibrillator (ICD) adverse events are poorly documented. In the NCDR ICD Registry™, a nationally representative cohort, we calculated the rate of long-term post-discharge device related adverse events. Methods: We included first-time ICD implants from 2006-2010 that could be matched with Medicare fee-for-service claims data to identify outcomes. We excluded patients if they had a previous ICD or pacemaker, CABG during their procedure, or were not discharged alive. The primary outcome was device reoperation (involving the generator, leads, pocket, or a combination) for device malfunction, infection, other complications (wound disruption, cardiac perforation, etc.), or reoperation for battery end-of-life and/or device upgrade. Analysis was performed using unadjusted cumulative incidence functions taking into consideration the competing risk of death. Results: We identified 185,263 ICD implants of which 114,649 (19.7% single-chamber, 41.3% dual-chamber, 38.8% CRT-D) could be matched to Medicare data (mean age 74.8±6.2 years, 72.5% male).Of these, 83.5% were for primary prevention of sudden cardiac death. The median follow up was 2.7 yrs (max follow-up 6 yrs). At least 1 reoperation occurred in 15.5% of patients by 6 yrs and more than 80% of these reoperations occurred after the early (>90 days) post-implantation period (Figure). Reoperation rates for specific complications (per 1000 patient yrs) were device malfunction (14.3), infection (5.1), other device related complications (18.4) and reoperation for generator battery end-of-life and/or device upgrade (12.9). The crude reoperation rate (for any cause) was similar among device types (P=0.19). Conclusion: Patients continue to have adverse outcomes in the years post ICD implantation, predominately from device malfunction. Our next steps are to identify patient, device, and provider factors associated with these long-term adverse events.

scholarly journals New onset depression and anxiety in patients with an implantable cardioverter defibrillator during 24 months of follow-up

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
SS Pedersen ◽  
JC Nielsen ◽  
S Wehberg ◽  
OD Jorgensen ◽  
S Riahi ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Physical Functioning ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Cardioverter Defibrillator ◽  
Type D ◽  
Anxiety Depression ◽  
First Time ◽  
New Onset

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Danish Heart Foundation OnBehalf DEFIB-WOMEN study group Background Patients adjust well to living with an implantable cardioverter defibrillator (ICD), but 20% develop anxiety and depression that may compromise their quality of life (QoL) and increase risk of ventricular tachyarrhythmias and mortality. Purpose We examined the incidence and correlates of new onset anxiety and depression during 24 months of follow-up in ICD patients without depression and anxiety. Methods Patients with a first-time ICD (n = 1040) enrolled in the national, multi-centre prospective observational DEFIB-WOMEN study completed questionnaires on anxiety, depression and physical QoL at baseline, 3-, 6-, 12-, and 24 months. Information on demographic and clinical data was obtained from the Danish Pacemaker and ICD Register. Results During 24 months of follow-up, 46-57 (4%-5%) patients developed new onset anxiety and 42-47 (4%-5%) new onset depression. The incidence of new onset comorbid anxiety and depression was higher with 69-80 (7%-8%). Age [HR:0.54; 95%CI:0.36-0.80], marital status [HR:1.66; 95%CI:1.01-2.73], secondary prevention indication [HR:1.43; 95%CI:1.00-2.04], Type D personality [HR:2.50; 95%CI:1.62-3.86], and lower self-reported physical functioning [HR:1.48; 95%CI:1.00-2.17] were associated with new onset anxiety during follow-up. Age [HR:0.57; 95%CI:0.37-0.89], higher self-reported physical functioning [HR:0.46; 95%CI:0.25-0.85], smoking [HR:2.13; 95%CI:1.33-3.40], Type D personality [HR:2.53; 95%CI: 1.57-4.05], and lower self-reported physical functioning [HR:1.64; 95%CI:1.08-2.48] were associated with new onset depression. Conclusion Between 4%-8% of patients with a first-time ICD with no anxiety or depression at baseline are at risk of new onset anxiety, depression, or comorbid anxiety and depression up to 24 months post implant, suggesting that safeguarding their QoL and prognosis warrants that we screen patients not only at baseline.

scholarly journals Undetected displacement of a subcutaneous implantable cardioverter-defibrillator lead. importance of performing a chest X-ray during the first weeks post-implant: a case report

2019 ◽  
Author(s):  
Jose Apolo ◽  
Rodolfo San Antonio ◽  
Lluís Mont ◽  
José María Tolosana
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Ventricular Arrhythmias ◽  
Xiphoid Process ◽  
Icd Implantation ◽  
X Ray ◽  
Cardioverter Defibrillator ◽  
Case Summary ◽  
Chest X Ray ◽  
Defibrillator Lead

Abstract Background In recent years, subcutaneous implantable cardioverter-defibrillator (S-ICD) implants have progressively increased and have been shown to be safe and highly successful, affording low reintervention rates regardless of the technique used. Case summary We present a case of S-ICD implantation in a patient diagnosed with idiopathic ventricular fibrillation. In the first follow-up consultation the patient showed appropriate detection parameters in the three configurations. However, chest X-ray revealed lead displacement with a tip migration from the manubrium area of the sternum to the xiphoid process. Discussion This case highlights the importance of performing at least one chest X-ray during the first weeks after S-ICD implantation, allowing the detection of a problem such as lead displacement, which can lead to undersensing of ventricular arrhythmias or S-ICD oversensing.

scholarly journals Genetic Clues on Implantable Cardioverter-Defibrillator Placement in Young-Age Hypertrophic Cardiomyopathy: A Case Report of Novel MYH7 Mutation and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Xing Li ◽  
Jie Tang ◽  
Jinhui Li ◽  
Sha Lin ◽  
Tao Wang ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Literature Review ◽  
Implantable Cardioverter Defibrillator ◽  
Pediatric Patients ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Heterozygous Mutation ◽  
Icd Implantation ◽  
Cardioverter Defibrillator

Background: Hypertrophic cardiomyopathy (HCM) is the second most common cardiomyopathy in childhood with a life-threatening risk. Implantable cardioverter-defibrillator (ICD) placement is recommended for early prevention if there are two or more clinical risk factors. Pediatric patients with HCM are at a higher risk of sudden cardiac death (SCD), but there are limited reports on indications for ICD implantation in children. Herein we describe the case of Myh7 mutation-induced HCM and cardiac arrest in a patient and evaluated information originating from genetic background to guide ICD administration.Case Presentation: The patient was a girl aged 7 years and 8 months who had been diagnosed with cardiomyopathy in utero 8 years prior. She had had recurrent cardiac arrests within the last 4 years. Electrocardiography indicated abnormalities in conduction, and ST segment changes. Echocardiography indicated significant left ventricular hypertrophy and hypertrophic systolic interventricular septum. Cardiac magnetic resonance imaging depicted general heart enlargement with hypertrophy, and delayed enhancement in myocardium with perfusion defect was also evident. Whole exon sequencing identified a de novo c.2723T&gt;C (p.L908P) heterozygous mutation in the MYH7 gene. MYH7 p.L908P predicted unstable protein structure and impaired function. The patient was scheduled for ICD implantation. There were no complications after ICD implantation, and she was discharged from hospital on the 10th day. Regular oral beta-blockers, amiodarone, spironolactone, and enalapril were administered, and she was required to attend hospital regularly for follow-up. During follow-up there were no cardiac arrests. Literature review of clinical prognoses associated with genetic mutations of MYH7, MYBPC3, TNNI3, TNNT2, and TPM1 in pediatric HCM patients with and without ICD implantation indicated that they were totally differently. Previous reports also indicated that gene mutations predicted earlier onset of cardiac hypertrophy, and increase likelihood of SCD.Conclusion: Variant burden and variant type contribute to the risk of adverse events in pediatric HCM. Early recognition and intervention are vital in children. Gene mutation could be considered an indication for early ICD placement during standard risk stratification of HCM patients. Whether this extends to the majority of pediatric patients requires further investigation.

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