Age- and gender-related differences in emotional reactions of patients related to their implantable cardioverter defibrillator

Implantable cardioverter-defibrillators (ICDs) are standard of care in the prevention of sudden cardiac death. It is known that ICD shocks can provoke acute stress reactions as well as posttraumatic stress disorders. However, emotional reactions regarding cardiac implantable electronic devices (CIEDs) are often underappreciated in clinical practice.

We aimed to survey patients with ICDs about their feelings related to their CIEDs, focusing on fear, indifference, grief, gratitude, hope, anger, uncertainty, trust, despair and worries. Additionally, we wanted to determine how these emotional perceptions vary across different ages and between male and female patients.

We conducted telephone interviews with 59 patients with ICDs as part of the HEARTBEAT study to assess their feelings regarding their CIEDs. For this purpose, patients were asked whether they experience the mentioned feelings towards their ICD or not. Statistical correlations between emotional perceptions, age and gender were calculated using the Spearman correlation coefficient.

The most frequently reported feelings towards the ICD were trust, gratitude and hope (Table 1). 20% of the surveyed patients reported experiencing fear regarding their ICD. Similarly, 36% of the surveyed patients feel uncertainty regarding their ICD. Grief and uncertainty were more frequently reported by patients under the age of 50 years than by older patients (Table 1). More female patients reported despair, uncertainty and worries regarding their ICD (Figure 1). There was no association between emotional perceptions and prior adequate as well as inadequate ICD shocks.

Our survey shows that the majority of patients with ICD feel trust, hope, and gratitude towards their ICD. However, a significant proportion of patients also experience fear and uncertainty regarding their CIED. This needs to be given more attention in cardiological care. Additionally, greater focus should be placed on young and female patients. Emotional strain does not appear to be necessarily related to prior ICD shocks. Further research with larger sample sizes is necessary to confirm our results.Table 1:

emotional perceptions (%)