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Do Patients Accept Implantable Atrial Defibrillation Therapy?
Author(s) -
BURNS JASON L.,
SEARS SAMUEL F.,
SOTILE REBECCA,
SCHWARTZMAN DAVID S.,
HOYT ROBERT H.,
ALVAREZ LUIS G.,
UJHELYI MICHAEL R.
Publication year - 2004
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2004.03406.x
Subject(s) - medicine , atrial fibrillation , implantable cardioverter defibrillator , defibrillation , quality of life (healthcare) , psychosocial , anxiety , cardiology , physical therapy , psychiatry , nursing
The Medtronic Jewel AF 7250 is an implantable cardioverter defibrillator with atrial and ventricular therapies (ICD‐AT). The ICD‐AT is effective in managing atrial tachyarrhythmias (atrial fibrillation [AF]), but patient acceptance remains an issue. This aim of this study was to measure ICD‐AT acceptance. Methods and Results: ICD‐AT acceptance was evaluated in 96 patients enrolled in the “Jewel AF‐AF‐Only Study” for ≥3 months of follow‐up (mean 19 months). Patients were mostly men (72%; age 65 ± 12 years). Clinical data and a written survey (75% response rate) were used to quantify demographics, AF frequency and symptoms, atrial defibrillation therapy, quality of life (QOL), psychosocial distress, and ICD‐AT therapy acceptance. From implant to survey, AF symptom and severity scores decreased by 18% (P ≤ 0.05), and QOL (SF‐36) scores increased by 15% to 50% (P ≤ 0.05). ICD‐AT therapy acceptance was high, with 71.3% of patients scoring in the 75th percentile on the Florida Patient Acceptance Survey. ICD‐AT acceptance was correlated with the Physical Component Scale and Mental Health Component Scale scores of the SF‐36 (r = 0.28 and 0.35, respectively). ICD‐AT acceptance was negatively correlated with depressive symptomatology (r =–0.59), trait anxiety (r =–0.48), illness intrusiveness (r =–0.55), and AF symptom and severity scores (r =–0.26). ICD‐AT acceptance did not correlate with preimplant cardioversions, number of atrial shocks, AF episodes detected by the device, or device implant duration. Conclusion: Most patients accepted ICD‐AT therapy. Patients were more likely to accept ICD‐AT if they had less psychosocial distress, greater QOL, and lower AF symptom burden. (J Cardiovasc Electrophysiol, Vol. 15, pp. 286‐291, March 2004)