Kocaeli Med J. 2018; 7(1): 59-64 | DOI: 10.5505/ktd.2018.64325

The effect of shock therapies on health-related quality of life in patients with implantable cardioverter-defibrillator

Serdar Bozyel¹, Ayþen Aðaçdiken Aðýr^2
1University of Health Sciences, Derince Training and Research Hospital, Department of Cardiology
²Kocaeli University, School of Medicine, Department of Cardiology

INTRODUCTION: Implantable cardioverter defibrillators (ICDs) reduce mortality from sudden cardiac death (SCD) effectively. However, ICD discharge, whether appropriate or inappropriate, represents a particularly challenging psychological event and is associated with poor quality of life (QoL). We aimed to investigate the association of shock and the health-related QoL.
METHODS: Patients implanted with either single, dual chamber ICDs or CRT-D devices were included. When they presented at our clinic for regular device follow-up, they completed the Short-Form Health Survey 36 (SF-36) at baseline and 12 months. Clinical parameters and device measurements were recorded.
RESULTS: A total of 217 patients, including 161 (74%) males with a mean age of 62±12 years, were included in the study. We excluded 10 (4.6%) patients that died during the follow-up. The mean age of the remaining 207 patients (53 female and 154 male) was 62±12 years. During the follow-up, 26 (12.6%) patients experienced shock therapy. Six-teen of them had appropriate and 10 of them had inappropriate shocks. Two or more shocks were delivered in 18 (8.7%) patients. Health status patterns were poor in patients received shock therapies during follow-up period.
DISCUSSION AND CONCLUSION: ICD shocks were associated with impaired health- related QoL. So, routine consideration of psychosocial situation needs to be integrated into the clinical care of ICD patients.

Keywords: Implantable cardioverter-defibrillator, shock theraphy, quality of life

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Ýmplantabl kardiyoverter-defibrilatör takýlan hastalarda þok tedavisinin hasta saðlýk iliþkili yaþam kalitesine etkisi

Serdar Bozyel¹, Ayþen Aðaçdiken Aðýr^2
1Saðlýk Bilimleri Üniversitesi, Derince Eðitim ve Araþtýrma Hastanesi, Kardiyoloji Kliniði
²Kocaeli Üniversitesi Týp Fakültesi Kardiyoloji ABD

GÝRÝÞ ve AMAÇ: Ýmplantabl kardiyoverter-defibrilatörler (ÝKD' ler) ani kardiyak ölümün önüne geçerek, mortaliteyi etkin bir þekilde azaltmaktadýr. Bununla birlikte, uygun ya da uygunsuz, ÝKD þoklamasý, özellikle aþýlmasý zor psikolojik süreçlere yol açar ve de kötü yaþam kalitesi ile iliþkilidir. Çalýþmamýzda, þoklama ile saðlýk iliþkili yaþam kalitesi arasýndaki iliþkiyi göstermeyi amaçladýk.
YÖNTEM ve GEREÇLER: Tek, iki ya da üç odacýklý (Kardiyak resenkronizasyon tedavisi-defibrilatör (KRT-D) ) ÝKD implante edilmiþ hastalar dahil edildi. Kliniðimize rutin cihaz kontrolü için baþvuran hastalar, baþvuruda ve 12. ayda Kýsa Form-36 saðlýk anketini tamamladýlar. Klinik parametreler ve cihaz ölçümleri kayýt altýna alýndý.
BULGULAR: Yaþ ortalamasý 62±12 olan, 161'i (74%) erkek toplam 217 hasta çalýþmaya dahil edildi. Takiplerde ölüm gerçekleþen 10 (4.6%) hasta çalýþma dýþýna alýndý. Kalan 207 hastanýn yaþ ortalamasý 62±12 idi. Takiplerde 26 (12.6%) hasta þoklama tedavisi aldý. 16 hasta uygun; 10 hasta is uygunsuz þok tedavisi aldý. 18 hastada 2 ya da daha fazla þok tedavisi saptandý. Saðlýk durumu parametreleri, þoklama tedavisi gören hastalarda daha kötü saptandý.
TARTIÞMA ve SONUÇ: ÝKD þoklama tedavisi, kötüleþmiþ hasta yaþam kalitesi ile iliþkilidir. Dolayýsýyla, rutin psikolojik durum deðerlendirmesi, ÝKD hastalarýnýn klinik takiplerine dahil edilmelidir.

Anahtar Kelimeler: Ýmplantabl kardiyoverter defibrilatör, þok tedavisi, yaþam kalitesi

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