Quality of life predicts one-year survival in patients with implantable cardioverter defibrillators

Abstract

Purpose: This study examines the contributions of known predictors of survival and quality of life (QOL) to 1-year survival in ICD recipients.

Methods: This study used the data set from the antiarrhythmia versus implanted defibrillator (AVID) controlled clinical trial conducted by the National Institutes of Health, National Heart, Lung, and Blood Institute. The 507 patients randomly assigned to the ICD treatment were included in the analysis. Patients were mostly male (78.3%), with mean age of 64.85 +/- 10.81 and mean left ventricular ejection fraction of 32.2 +/- 13.45%. QOL was measured with the medical outcomes study 36-item short form health survey (SF-36) and quality of life index-cardiac version (QLI-CV). Data were analyzed with descriptive statistics and logistic regression.

Results: Fifty-four (10.6%) patients died in the first year after ICD implantation. Angiotensin-converting enzyme inhibitor (ACE) medication, age, and QLI-CV were significant independent predictors of 1-year survival. The odds of survival of a younger patient with ACE medication and good QOL were approximately three times (OR = 3.96) greater than for an older patient, without ACE medication and with poor QOL.

Conclusion: Quality of life is an important factor predicting 1-year survival in patients with ICDs. ACE medication and younger age also predict 1-year survival independent of QOL and each other.