Psychological aspects of cardiac devices and recalls in patients with implantable cardioverter defibrillators.

The product recall of an implantable cardioverter defibrillator (ICD) creates a potentially stressful event for patients. This study briefly describes the psychological adjustment of patients with implantable devices and makes recommendations for the management of device recalls and adverse outcomes to minimize psychological distress. Because the occurrence of ICD-specific fears and symptoms of anxiety are the most common psychological symptoms experienced by ICD recipients, a comprehensive care plan to attend to recall procedures and patient distress is needed. It is suggested that recalls do not affect all ICD patients equally, with risk factors for poor psychological adjustment to ICDs including younger age (< 50 years), shock experience, and female gender that may be associated with increased recall anxiety. Specific recommendations for device recall management include formalizing clinic responses to recall before and after implantation and innovative uses of patient support systems to communicate recall responses.