Article thumbnail
Location of Repository

Quality of Life in Patients with Implantable Cardioverter Defibrillators

By Johnson Francis, Beena Johnson and Michael Niehaus


Background: The implantable cardioverter defibrillator (ICD) is a life saving device for individuals with life threatening ventricular arrhythmias. There is no doubt that it is a cost effective therapy in various congenital and acquired arrhythmogenic disorders. Nevertheless, shock delivery may be painful and frightening which causes psychological distress and deterioration of perceived quality of life. Methods: A systematic meta-analysis on studies reporting quality of life in patients implanted with ICDs was done using professional databases. Related articles and references of the relevant articles were also searched for suitable studies. Results: Thirty studies with a total of 3412 patients on implantable defibrillators were identified. Five of them were large randomised studies with a total of 1680 patients, while 25 were non-randomised studies. Medical Outcome Study 36-item Short Form health survey (SF - 36) was the most common instrument used for assessment of quality of life. Only one of the 5 major randomised trial reported worsening of quality of life after implantation of a defibrillator. In the subgroup of patients receiving shocks, three out of the five trials reported worsening of quality of life. Summary: Most of the randomised studies showed either neutral or better quality of life in patients on implantable defibrillators. In the subset of patients receiving shocks, worsening of quality of life was found in most randomised studies. Therefore, activation of antitachycardia pacing should be performed in every ICD-patient in order to miminze painful shocks and consequent deterioration of quality of life

Topics: Indian Pacing and Electrophysiology Journal
Publisher: Indian Pacing and Electrophysiology Group
Year: 2006
OAI identifier:

Suggested articles


  1. A 12-month quality of life assessment of cardiac arrest survivors treated with or without an implantable cardioverter defibrillator.
  2. (1997). Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators: A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from nearfatal ventricular arrhythmias.
  3. Changes in health status, psychological distress, and quality of life in implantable cardioverter defibrillator recipients between 6 months and 1 year after implantation.
  4. (2004). Determinants of the quality of life (QoL) in patients with an implantable cardioverter/defibrillator (ICD). Qual Life Res. doi
  5. Do positive health expectations and optimism relate to quality-of-life outcomes for the patient with an implantable cardioverter defibrillator? doi
  6. Dual defibrillator improves quality of life and decreases hospitalizations in patients with drug refractory atrial fibrillation. doi
  7. Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator. doi
  8. (1999). Health-related quality-of-life assessment of patients with life-threatening ventricular arrhythmias. Pacing Clin Electrophysiol.
  9. How different from pacemaker patients are recipients of implantable cardioverter-defibrillators with respect to psychosocial adaptation, affective disorders, and quality of life?
  10. (1996). Improved appraisal of the quality of life in patients with automatic implantable cardioverter defibrillator: a psychometric study. Psychother Psychosom.
  11. (1996). Improved survival with an implantable defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial (MADIT) Investigators.
  12. Life after a ventricular arrhythmia.
  13. Longitudinal recovery following sudden cardiac arrest and internal cardioverter defibrillator implantation: survivors and their families.
  14. Morady F; AMIOVIRT Investigators. Amiodarone versus implantable cardioverterdefibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia - doi
  15. Overview of randomized trials of antiarrhythmic drugs and devices for the prevention of sudden cardiac death.
  16. (1993). Patient acceptance of the implantable cardioverter defibrillator in ventricular tachyarrhythmias. Pacing Clin Electrophysiol.
  17. (2006). Perceived quality of life before and after implantation of an internal cardioverter defibrillator.
  18. Predictors of quality of life in long-term recipients of implantable cardioverter defibrillators.
  19. Quality of life after use of the patient activated atrial defibrillator. doi
  20. Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocks.
  21. (2006). Quality of life in the Canadian Implantable Defibrillator Study (CIDS).
  22. (1995). Quality of life in younger persons with an implantable cardioverter defibrillator. Dimens Crit Care Nurs.
  23. (1999). Quality-of-life six months after CABG surgery in patients randomized to ICD versus no ICD therapy: findings from the CABG Patch Trial. Pacing Clin Electrophysiol.
  24. (1992). Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. doi
  25. The effects of age on quality of life in implantable cardioverter defibrillator recipients. doi
  26. (1995). The impact of the implantable cardioverter defibrillator on quality-of-life. Pacing Clin Electrophysiol.
  27. (1995). The quality of life of patients with life-threatening arrhythmias. Arch Intern Med.
  28. (2006). Volosin KJ; PainFREE Rx II Investigators. Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for Indian Pacing and Electrophysiology
  29. Worldwide Jewel AF AF-Only Investigators. Effect of an implantable cardioverter defibrillator with atrial detection and shock therapies on patient-perceived, healthrelated quality of life.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.