An implanted defibrillator may give heart arrhythmia patients peace of mind when it comes to their physical well-being. Keeping an eye on their emotional well being, however, is just as important.
American Heart Association officials have recommended in a new scientific statement that patients who receive an implantable cardioverter defibrillator (ICD) receive improved education and continuing psychological support.
The suggested support includes routine screenings for depression, anxiety and post traumatic stress disorder.
Individuals with arrhythmias such as atrial fibrillation generally receive the defibrillators to restore normal heart rhythm and prevent sudden cardiac death.
Sandra B. Dunbar, RN, DSN, chair of the statement writing group and the Charles Howard Candler Professor at the Nell Hodgson Woodruff School of Nursing at Emory University, noted that an ICD shock can be lifesaving, but it can affect a person's quality of life and psychological state.
Dunbar said that experiencing a shock is distressing for patients and each may respond differently afterward, with some feeling reassured that the device works while others feel scared and overwhelmed.
The issue is of particular importance based on the sheer number implanted each year in the U.S. She said that about 10,000 ICDs are implanted each month in individuals ranging from elderly heart failure patients to healthy children with a gene that makes them prone to sudden cardiac arrest.
The statement recommends that doctors assess a patient's concerns and psychological status at each follow-up visit, and that they help individuals and their families cope with stress related to the ICD.
Clinicians also should educate patients, emphasizing that the ICD protects against sudden death but will not help with the underlying heart condition unless the device is equipped to offer certain pacing, the statement notes.
A "shock plan" also should be developed so that individuals and their families know what to do if a shock occurs.
The statement was recently published in American Heart Association journal Circulation.