Frydensberg Vivi S, Skovbakke Søren J, Pedersen Susanne S, Kok Robin N
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
Pacing Clin Electrophysiol. 2018 Sep;41(9):1235-1260. doi: 10.1111/pace.13421. Epub 2018 Aug 6.
Patients with an implantable cardioverter defibrillator (ICD) retain a scar and a bump at the site of implant. This may lead to body image concerns (BICs) that influence patients' quality of life. Few studies have examined the prevalence and impact of BICs postimplant, prompting us to conduct a scoping review of the field.
We searched the Medline, Embase, PsycINFO, and Cinahl databases in August 2016 and repeated in May 2017. Included were studies reporting on patients ≥ 18 years, an ICD implant (transvenous, subcutaneous, or ICD with cardiac resynchronization therapy [CRT-D]), reporting on BICs, and published in peer-reviewed English-language journals. We excluded nonsystematic reviews, opinion pieces/letters, case studies, conference abstracts, PhD dissertations, protocol papers, studies of ICD shock treatment of atrial fibrillation, and of abdominally or submammary implanted ICDs.
A total of 40 articles were included: 16 qualitative and 24 quantitative. None of the included studies had BICs as their primary endpoint. Results showed that BICs are present in various degrees in the ICD population and can be attributed to the visibility of the ICD (the scar and bump). Women and younger patients had greater problems with BICs, although men also had concerns. Two items of the "Florida Patient Acceptance Survey" were the most frequently used to assess BICs.
BICs were present among ICD patients, but the degree of impact on their lives varied. There is a need for developing a BICs questionnaire to examine the prevalence of BICs and the potential impact on patients' lives in longitudinal studies.
植入式心脏复律除颤器（ICD）患者的植入部位会留下疤痕和隆起。这可能会导致影响患者生活质量的身体形象问题（BIC）。很少有研究调查植入后BIC的患病率和影响，促使我们对该领域进行一项范围综述。
我们于2016年8月检索了Medline、Embase、PsycINFO和Cinahl数据库，并于2017年5月重复检索。纳入的研究报告对象为年龄≥18岁的患者、ICD植入（经静脉、皮下或带有心脏再同步治疗[CRT-D]的ICD）、报告BIC情况且发表在同行评审英文期刊上。我们排除了非系统性综述、观点文章/信件、病例研究、会议摘要、博士论文、方案论文、关于ICD治疗心房颤动休克的研究以及腹部或乳房下植入ICD的研究。
共纳入40篇文章：16篇定性研究和24篇定量研究。纳入的研究均未将BIC作为主要终点。结果表明，ICD人群中存在不同程度的BIC问题，并可归因于ICD的可见性（疤痕和隆起）。女性和年轻患者在BIC方面问题更大，不过男性也有担忧。“佛罗里达患者接受度调查”中的两项是最常用于评估BIC的项目。
ICD患者中存在BIC问题，但对其生活的影响程度各不相同。有必要开发一份BIC问卷，以在纵向研究中调查BIC的患病率及其对患者生活的潜在影响。
