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Quality of life, depression, and anxiety in patients with a subcutaneous versus transvenous defibrillator system

Pedersen, SS; Carter, N; Barr, C; Scholten, M; Lambiase, PD; Boersma, L; Johansen, JB; (2019) Quality of life, depression, and anxiety in patients with a subcutaneous versus transvenous defibrillator system. PACE: Pacing and Clinical Electrophysiology , 42 (12) pp. 1541-1551. 10.1111/pace.13828. Green open access

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Abstract

Background: Use of the subcutaneous implantable defibrillator (S‐ICD) has increased because the device received US Food and Drug Administration approval in 2012, but we still know little about whether the quality of life (QoL) of patients with an S‐ICD versus a transvenous ICD (TV‐ICD) is comparable. We compared S‐ICD patients with TV‐ICD patients on QoL, depression, and anxiety up to 12 months’ follow‐up. Methods: A matched cohort of S‐ICD (N = 167) and TV‐ICD patients (N = 167) completed measures on QoL, depression, anxiety, and personality at baseline, 3, 6, and 12 months post implant. Data were analyzed using multivariable modeling with repeated measures. Results: In adjusted analyses, we found no statistically significant differences between cohorts on physical and mental QoL and depression (all Ps > .05), while S‐ICD patients reported lower anxiety than TV‐ICD patients (P = 0.0007). Both cohorts experienced improvements in physical and mental QoL and symptoms of depression and anxiety over time (all Ps < .001), primarily between implant and 3 months. These improvements were similar for both cohorts with respect to physical and mental QoL and anxiety (Ps > .05), while S‐ICD patients experienced greater reductions in depressive symptoms (P = .0317). Conclusion: The QoL and depression levels were similar in patients with an S‐ICD and a TV‐ICD up to 12 months’ follow‐up, while S‐ICD patients reported lower anxiety levels and a greater reduction in depression over time as compared to TV‐ICD patients. This knowledge may be important for patients and clinicians, if the indication for implantation allows both the S‐ICD and the TV‐ICD, making a choice possible.

Type: Article
Title: Quality of life, depression, and anxiety in patients with a subcutaneous versus transvenous defibrillator system
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/pace.13828
Publisher version: http://doi.org/10.1111/pace.13828
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: anxiety, depression, implantable cardioverter defibrillator, quality of life
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10088850
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