School of Nursing, Purdue University College of Health and Human Science, West Lafayette, IN, USA.
Division of Pediatric Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
Pediatr Cardiol. 2023 Dec;44(8):1721-1725. doi: 10.1007/s00246-023-03264-0. Epub 2023 Aug 13.
Pediatric and adult congenital heart disease (ACHD) patients encounter physical and emotional barriers. Cardiac implantable electronic devices (CIEDs), including pacemakers and implantable cardiac defibrillators (ICD) often compound these issues. Patient fear associated with damaging the CIED system can lead to avoidance of physical activity and reduced quality of life (QOL). CIED personal protective equipment (PPE) is a potential treatment for decreasing this fear. We sought to determine the effects of CIED PPE use in the pediatric and ACHD population. Patients 5 years or older with a CIED at a single pediatric and ACHD heart rhythm center received a CIED protector and customized athletic shirt. QOL was assessed using the PedsQL TM 4.0 SF15 prior to and after 6-12 months. Of the 77 patients enrolled, 26 completed repeat assessment. The mean age at enrollment was 15.6 years (range 5-36) with a mean device age of 2.2 years (< 1-10 years). Pacemakers were present in 77% and 23% had ICDs. The PPE was used in 92% with no PPE malfunction. Fear associated with physical activity was reduced, z = - 4, p < 0.001, with a large effect size (r = 0.55). There was a trend toward increased physical activity. Total QOL scores improved, z = - 2.771, P < 0.05, with a medium effect size (r = 0.4). This first study of CIED PPE in children shows that providing CIED PPE to pediatric and ACHD patients may decrease their fear of damaging their device system, increasing physical activity levels, and improving quality of life.
儿科和成人先天性心脏病（ACHD）患者会遇到身体和情绪方面的障碍。心脏植入式电子设备（CIED），包括起搏器和植入式心脏除颤器（ICD），常常会使这些问题更加复杂。患者对损坏 CIED 系统的恐惧可能导致他们避免进行身体活动，从而降低生活质量（QOL）。CIED 个人防护设备（PPE）是降低这种恐惧的一种潜在治疗方法。我们旨在确定 CIED PPE 在儿科和 ACHD 人群中的使用效果。在一家儿科和 ACHD 心脏节律中心，对 77 名年龄在 5 岁及以上、携带 CIED 的患者发放了 CIED 保护器和定制运动衫。在使用 CIED PPE 6-12 个月前后，使用 PedsQL TM 4.0 SF15 评估 QOL。在 77 名入组患者中，有 26 名完成了重复评估。入组时的平均年龄为 15.6 岁（范围 5-36 岁），设备平均使用年限为 2.2 年（<1-10 年）。77%的患者携带起搏器，23%的患者携带 ICD。92%的患者使用了 PPE，且没有出现 PPE 故障。与身体活动相关的恐惧减少，z=-4，p<0.001，效应量较大（r=0.55）。身体活动量有增加的趋势。总体 QOL 评分提高，z=-2.771，P<0.05，效应量中等（r=0.4）。这项关于儿科 CIED PPE 的首次研究表明，为儿科和 ACHD 患者提供 CIED PPE 可能会降低他们对损坏设备系统的恐惧，增加身体活动水平，并改善生活质量。
