Shock as a determinant of poor patient-centered outcomes in implantable cardioverter defibrillator patients

is there more to it than meets the eye?

Susanne S. Pedersen, Krista C Van Den Broek, Martha Van Den Berg, Dominic A M J Theuns

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

The medical benefits of the implantable cardioverter defibrillator (ICD) are well established, but ICD shocks are known to influence patient-centered outcomes. In this viewpoint, we examine the strength of the evidence as found in primary and secondary prevention trials that used quality of life as an outcome, and compare the influence of ICD shock with other factors (e.g., heart failure and psychological factors) as determinants of outcomes, with a view to providing recommendations for clinical practice and future research. Based on the large-scale primary and secondary prevention trials (i.e., CABG-PATCH, CIDS, AVID, AMIOVIRT, SCD-HeFT, MADIT-II, and DEFINITE), evidence for an association between ICD shocks and quality of life is mixed, with some indication that the influence of shocks may depend largely on the interval between shocks and assessment of quality of life. In order to improve the clinical management of ICD patients, we need to adopt a more rigorous and standardized methodology in future studies in order to be able to draw firm conclusions about the impact of ICD shocks on individual patients. We also need to acknowledge that the impact of shocks on psychological functioning and quality of life may not be as straightforward as previously assumed. Given that programming of the ICD is changing, leading to fewer shocks and improved quality of life, it may be timely to also examine the influence of other determinants (e.g., heart failure progression and the patient's psychological profile) of patient-centered outcomes both in research and in clinical practice.
OriginalsprogEngelsk
TidsskriftMonografi: ISSN 1046-7750
Vol/bind33
Udgave nummer12
Sider (fra-til)1430-6
Antal sider7
ISSN0893-5394
DOI
StatusUdgivet - dec. 2010

Fingeraftryk

Implantable Defibrillators
quality of life
determinants
Quality of Life
Primary Prevention
psychological factors
evidence
indication
programming
methodology
management
Research

Citer dette

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abstract = "The medical benefits of the implantable cardioverter defibrillator (ICD) are well established, but ICD shocks are known to influence patient-centered outcomes. In this viewpoint, we examine the strength of the evidence as found in primary and secondary prevention trials that used quality of life as an outcome, and compare the influence of ICD shock with other factors (e.g., heart failure and psychological factors) as determinants of outcomes, with a view to providing recommendations for clinical practice and future research. Based on the large-scale primary and secondary prevention trials (i.e., CABG-PATCH, CIDS, AVID, AMIOVIRT, SCD-HeFT, MADIT-II, and DEFINITE), evidence for an association between ICD shocks and quality of life is mixed, with some indication that the influence of shocks may depend largely on the interval between shocks and assessment of quality of life. In order to improve the clinical management of ICD patients, we need to adopt a more rigorous and standardized methodology in future studies in order to be able to draw firm conclusions about the impact of ICD shocks on individual patients. We also need to acknowledge that the impact of shocks on psychological functioning and quality of life may not be as straightforward as previously assumed. Given that programming of the ICD is changing, leading to fewer shocks and improved quality of life, it may be timely to also examine the influence of other determinants (e.g., heart failure progression and the patient's psychological profile) of patient-centered outcomes both in research and in clinical practice.",
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Shock as a determinant of poor patient-centered outcomes in implantable cardioverter defibrillator patients : is there more to it than meets the eye? / Pedersen, Susanne S.; Van Den Broek, Krista C; Van Den Berg, Martha; Theuns, Dominic A M J.

I: Monografi: ISSN 1046-7750, Bind 33, Nr. 12, 12.2010, s. 1430-6.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Shock as a determinant of poor patient-centered outcomes in implantable cardioverter defibrillator patients

T2 - is there more to it than meets the eye?

AU - Pedersen, Susanne S.

AU - Van Den Broek, Krista C

AU - Van Den Berg, Martha

AU - Theuns, Dominic A M J

N1 - ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

PY - 2010/12

Y1 - 2010/12

N2 - The medical benefits of the implantable cardioverter defibrillator (ICD) are well established, but ICD shocks are known to influence patient-centered outcomes. In this viewpoint, we examine the strength of the evidence as found in primary and secondary prevention trials that used quality of life as an outcome, and compare the influence of ICD shock with other factors (e.g., heart failure and psychological factors) as determinants of outcomes, with a view to providing recommendations for clinical practice and future research. Based on the large-scale primary and secondary prevention trials (i.e., CABG-PATCH, CIDS, AVID, AMIOVIRT, SCD-HeFT, MADIT-II, and DEFINITE), evidence for an association between ICD shocks and quality of life is mixed, with some indication that the influence of shocks may depend largely on the interval between shocks and assessment of quality of life. In order to improve the clinical management of ICD patients, we need to adopt a more rigorous and standardized methodology in future studies in order to be able to draw firm conclusions about the impact of ICD shocks on individual patients. We also need to acknowledge that the impact of shocks on psychological functioning and quality of life may not be as straightforward as previously assumed. Given that programming of the ICD is changing, leading to fewer shocks and improved quality of life, it may be timely to also examine the influence of other determinants (e.g., heart failure progression and the patient's psychological profile) of patient-centered outcomes both in research and in clinical practice.

AB - The medical benefits of the implantable cardioverter defibrillator (ICD) are well established, but ICD shocks are known to influence patient-centered outcomes. In this viewpoint, we examine the strength of the evidence as found in primary and secondary prevention trials that used quality of life as an outcome, and compare the influence of ICD shock with other factors (e.g., heart failure and psychological factors) as determinants of outcomes, with a view to providing recommendations for clinical practice and future research. Based on the large-scale primary and secondary prevention trials (i.e., CABG-PATCH, CIDS, AVID, AMIOVIRT, SCD-HeFT, MADIT-II, and DEFINITE), evidence for an association between ICD shocks and quality of life is mixed, with some indication that the influence of shocks may depend largely on the interval between shocks and assessment of quality of life. In order to improve the clinical management of ICD patients, we need to adopt a more rigorous and standardized methodology in future studies in order to be able to draw firm conclusions about the impact of ICD shocks on individual patients. We also need to acknowledge that the impact of shocks on psychological functioning and quality of life may not be as straightforward as previously assumed. Given that programming of the ICD is changing, leading to fewer shocks and improved quality of life, it may be timely to also examine the influence of other determinants (e.g., heart failure progression and the patient's psychological profile) of patient-centered outcomes both in research and in clinical practice.

KW - Clinical Trials as Topic

KW - Defibrillators, Implantable

KW - Electric Countershock

KW - Heart Failure

KW - Humans

KW - Outcome Assessment (Health Care)

KW - Quality of Life

KW - Treatment Outcome

U2 - 10.1111/j.1540-8159.2010.02845.x

DO - 10.1111/j.1540-8159.2010.02845.x

M3 - Journal article

VL - 33

SP - 1430

EP - 1436

JO - American Indian and Alaska Native Mental Health Research (Online)

JF - American Indian and Alaska Native Mental Health Research (Online)

SN - 1533-7731

IS - 12

ER -