Tavenaux M, Ginzburg D M, Boukacem A, Sperzel J, Hamm C, Jordan J
Abteilung für Psychokardiologie, Kerckhoff-Klinik, Ludwigstr. 41, 61231, Bad Nauheim, Deutschland.
Herzschrittmacherther Elektrophysiol. 2011 Sep;22(3):174-9. doi: 10.1007/s00399-011-0144-z.
The psychological strain of an implantable cardioverter-defibrillator (ICD) is infrequently explored in prospective studies, which have until now generally focused on the dimensions anxiety and depression. Furthermore, vital exhaustion (VE; ICD10 F 48.0) is known as a very good predictor for negative outcome in patients with coronary heart disease. The influence of VE on patients with an ICD is presented and analyzed in a prospective study.
A total of 249 patients with an ICD completed a set of questionnaires (HADS, EQ-5D, VE) at baseline and at the 1-year follow-up.
The patients with high levels of depression, anxiety, and VE after ICD implantation did not show spontaneous remission after 1 year.
As expected, the implanatation of an ICD is associated with high acceptance and increased life quality in about 3/4 of patients. However, there is a subgroup of patients (20-30%) who have difficulties and the measured dimensions remain at elevated levels after implantation, thus, indicating that these patients probably need competent psychological help.
前瞻性研究中很少探讨植入式心脏复律除颤器（ICD）带来的心理压力，目前这类研究普遍聚焦于焦虑和抑郁方面。此外，心力疲惫（VE；国际疾病分类第10版F48.0）是冠心病患者不良预后的一个很好的预测指标。一项前瞻性研究展示并分析了VE对ICD患者的影响。
共有249例ICD患者在基线期和1年随访时完成了一组问卷调查（医院焦虑抑郁量表、EQ-5D量表、心力疲惫量表）。
ICD植入后抑郁、焦虑和VE水平较高的患者在1年后并未出现自发缓解。
正如预期的那样，约3/4的患者对ICD植入的接受度较高且生活质量有所提高。然而，有一个亚组患者（20%-30%）存在困难，植入后所测指标仍处于较高水平，因此表明这些患者可能需要专业的心理帮助。
