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The prevalence of anxiety among patients with implantable cardioverter defibrillator in single and multicenter studies

Session Poster Session 2

Speaker Associate Professor Robert Olszewski

Congress : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P544

Authors : P Zegarow (Warsaw,PL), M Manczak (Warsaw,PL), R Olszewski (Warsaw,PL)

P Zegarow1 , M Manczak1 , R Olszewski1 , 1National Institute of Geriatrics Rheumatology and Rehabilitation - Warsaw - Poland ,


INTRODUCTION:Currently it is believed that implantable cardioverter defibrillator (ICD) is the most effective method of primary and secondary prevention of sudden cardiac death due to ventricular arrhythmias. Although ICD saves lives, it can lead to psychological disturbance in many patients including anxiety and other form of psychological distress.

AIM: The aim of this meta-analysis was to assess the prevalence of anxiety among adults with an implantable cardioverter defibrillator. A more accurate estimate of anxiety prevalence than what is currently available is needed to gauge the potential impact of anxiety management among patients with implantable cardioverter defibrillator.

METHODS: A comprehensive search of articles that were published between 1996 and October 2018 was conducted using MEDLINE, PubMed, Web of Science, Scopus and Google Scholar. Data extraction was carried out by two independent researchers. The severity of anxiety symptoms in the included studies was measured by self-report questionnaires; Hospital Anxiety and Depression Scale (HADS). The quality of the included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model was used to estimate the pooled mean difference of these values between patients with ICD and the controls.

RESULTS: Eighteen (14 single-center and 4 multicenter) studies of the 591 search results met the inclusion criteria with data from 7161 patients (mean age 64 ± 12; 79.5% male,) with implantable cardioverter defibrillator - Tab.1. Patients with ICD in single-center studies reported higher prevalence of anxiety symptoms (HADS index = 8) compared to the patients with ICD in multicenter studies (24% vs 19%, p < 0.001) - Fig.1.

CONCLUSION: Based on existing data, it may be appropriate to estimate a 20% prevalence rate for anxiety symptoms among patients with ICD. Such a large group of patients, confirmed both in single and multi-center studies, should be subjected to some form of treatment (psychological intervention) to improve their quality of life.

Study (year)



HADS index ≥ 8


Thylen I.



65 ± 11.5




Berg SK.







Isrealssom J.



65 ± 12




Kapa S.



66 ±12




Johansen JB.



62 ± 14



Anxiety level in ICD patients, study with subjects > 200

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