Prospective survey of implantable defibrillator shock anxiety in Japanese patients: Results from the DEF‐Chiba study

• Published in: Pacing and clinical electrophysiology 2018-09, Vol.41 (9), p.1171-1177
• Main Authors: Miyazawa, Kazuo, Kondo, Yusuke, Ueda, Marehiko, Kajiyama, Takatsugu, Nakano, Masahiro, Inagaki, Masayuki, Schwab, Joerg O., Sears, Samuel F., Kobayashi, Yoshio
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety - psychology; Defibrillators; Defibrillators, Implantable - psychology; depression; Electric Countershock - psychology; Female; Florida Shock Anxiety Scale; Humans; implantable cardioverter defibrillator; implantable cardioverter defibrillator shock; Japan; Male; Middle Aged; Prospective Studies; Quality of life; Registration; Risk Factors; Shock; Surveys and Questionnaires
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.13442

Background Patient‐reported outcomes of implantable cardioverter defibrillator (ICD), such as those with shock anxiety, have emerged as important endpoints that are related to quality of life (QOL), but they have not been well studied in a sample of the Japanese population. Therefore, we prospectively examined changes in shock anxiety in a large sample of Japanese patients with an ICD. Methods We recruited 214 consecutive patients with an ICD who visited the outpatient clinic. At registration and 12 months later, all patients completed the Florida Shock Anxiety Scale (FSAS) questionnaire to allow us to examine changes in shock anxiety over the course of the first year after registration. Results During the 12‐month follow‐up period, 10.5% of the patients received ICD shock therapy. Female sex, secondary prevention, and experience of ICD shock therapy were associated with high FSAS scores at registration. The FSAS scores in both patients with appropriate and inappropriate shock were significantly higher at the 12‐month follow‐up interval than at registration, and there was no significant difference in the extent of changes in FSAS scores (Δ = 5.2 ± 5.1 and Δ = 6.3 ± 9.9, respectively, P = 0.62). Conclusions Female sex, secondary prevention, and experience of ICD shock therapy are important risk factors affecting shock anxiety in Japanese patients. Attention should be paid to the after‐effects of ICD shock in these patients, regardless of the shock type, with particular attention to women and patients who require secondary prevention.