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The Registry Evaluating Functional Outcomes of Resynchronization Management (REFORM): Quality of Life and Psychological Functioning in Patients Receiving Cardiac Resynchronization Therapy
Author(s) -
FORD JESSICA,
SEARS SAMUEL,
RAMZA BRIAN,
REYNOLDS DWIGHT W.,
NGUYEN PAUL,
FEDEWA MICHELLE,
HOUSE JOHN,
KENNEDY PAUL,
THOMPSON ROSE,
MURRAY CHRISTINA
Publication year - 2014
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/jce.12257
Subject(s) - medicine , cardiac resynchronization therapy , quality of life (healthcare) , anxiety , heart failure , psychosocial , physical therapy , depression (economics) , cardiology , ejection fraction , psychiatry , nursing , economics , macroeconomics
QoL and Psychosocial Outcomes of CRT. Background Cardiac resynchronization therapy (CRT) is a treatment for heart failure (HF) that improves cardiac, functional, and quality of life (QoL) outcomes. This study was designed to examine the effect of the addition of CRT (CRTD) to the implantable cardioverter defibrillator (ICD) on psychological functioning. Methods and Results Overall, 99 participants completed batteries before and 9 months after ICD or CRTD implantation in a registry of HF patients receiving device treatment in 3 US centers. Measures included validated indices of mental health (State Trait Anxiety Inventory, Patient Health Questionnaire: Depression) and generic and disease/device‐specific QoL (Medical Outcomes Study‐Short Form‐12, Kansas City Cardiomyopathy Questionnaire, Florida Patient Acceptance Survey, Florida Shock Anxiety Scale). Mixed between‐within analyses of covariance were employed to compare device groups on each outcome controlling for cardiac and demographic covariates. Clinically significant anxiety was elevated in both groups at both time points (57% CRTD at baseline, 29% CRTD 9 months, 44% ICD at baseline, 45% ICD 9 months). Clinically significant depressive symptoms were high at baseline (38% CRTD, 31% ICD), but dropped at follow‐up (16% CRTD, 7% ICD; P = 0.01). Participants with CRTD had improved mental component and disease‐specific QoL following CRT; however, CRTD patients had worse QoL, worse mental component QoL at baseline, and worse device acceptance at 9‐month follow‐up than patients with ICDs (all P < 0.05). Conclusions Evidence of low QoL, psychological functioning, and device acceptance provides the impetus to increase research on well‐being of HF patients being implanted with CRTD in research and clinical work.