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Observational Study
. 2021 Jul 9;11(7):e047053.
doi: 10.1136/bmjopen-2020-047053.

Health-related quality of life in patients with implantable cardioverter defibrillators in Sweden: a cross-sectional observational trial

Peter Magnusson  1   2   3 , Gustav Mattsson  2 , Marita Wallhagen  4 , Jan Karlsson  5
Affiliations
Observational Study

Health-related quality of life in patients with implantable cardioverter defibrillators in Sweden: a cross-sectional observational trial

Peter Magnusson et al. BMJ Open. .

Abstract

Objectives: Decisions regarding implantable cardioverter defibrillators (ICDs) must consider information about presumed health-related quality of life (HRQL). The purpose of the study was to assess HRQL in patients with ICD and compare it to a Swedish age-matched and sex-matched population.

Design: Cross-sectional observational trial.

Setting: Swedish ICD cohort.

Interventions: Short form 36 (SF-36) questionnaires from ICD recipients implanted 2007-2017 (response rate 77.2%) were analysed using Mann-Whitney U test and effect size (ES).

Results: In total, 223 patients (mean age 71.1±9.7 years, 82.1% men) were included. In most SF-36 domains (physical functioning (PF), role physical, general health (GH), vitality, social functioning and mental health), the score for patients with ICD was significantly lower (ES range 0.23-0.41, ie, small difference) than norms, except for bodily pain and role emotional. Both the physical component summary (PCS) and the mental component summary (MCS) scores had ES=0.31. Men and women had similar scores. Primary and secondary prevention patients scored similarly, except for worse GH in primary prevention (p=0.016, ES=0.35). Atrial fibrillation was associated with worse PF (ES=0.41) and PCS (ES=0.38). Appropriate therapy, inappropriate shock or complications requiring surgery were not associated with lower scores in any domain. In primary prevention due to ischaemic versus non-ischaemic cardiomyopathy, no domain was significantly different. PCS decreased with higher age strata (p=0.002) in contrast to MCS (p=0.986).

Conclusions: Patients with ICDs have lower physical and mental HRQL than age-matched and sex-matched norms; however, the ESs are small. HRQL is similar regardless of sex, primary/secondary prevention indication, appropriate therapy, inappropriate shock or complications, but decreases with advancing age.

Keywords: adult cardiology; cardiology; heart failure; pacing & electrophysiology.

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Conflict of interest statement

Competing interests: PM has received speaker fees or grants from Abbott, Alnylam, Amicus Therapeutics, Bayer, AstraZeneca, BMS, Boehringer‐Ingelheim, Internetmedicin, Lilly, MSD, Novo Nordisk, Octopus Medical, Pfizer, Vifor Pharma and Zoll. GM has received speaker fee from Alnylam, Internetmedicin and MSD.

Figures

Figure 1
Figure 1
Flowchart. ICD, implantable cardioverter defibrillator.
Figure 2
Figure 2
Bar chart: Health-related quality of life among patients with ICD compared with age-matched and sex-matched norms. BP, bodily pain; GH, general health; ICD, implantable cardioverter defibrillator; MH, mental health; PF, physical functioning; RE, role-emotional; RP, role-physical; SF, social functioning; VT, vitality.
See this image and copyright information in PMC

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