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Herzschrittmacherther Elektrophysiol. 2010 Jun;21(2):129-36. doi: 10.1007/s00399-010-0082-1.

[Psychological comorbidity and quality of life in patients with an implantable cardioverter/defribrillator (ICD)].

[Article in German]

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Institut für Epidemiologie, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Ingolstädter Landstr. 1, 85764, Neuherberg, Deutschland.


Currently, the method of choice for protection against sudden cardiac death for high-risk patients is ICD treatment. The CIDS study could prove a significant advantage of ICD treatment compared to amiodarone therapy. However, the survival advantages can be affected by the negative side effects of ICD therapy. The therapeutic survival function of the device is, in general, associated with a consciously experienced, at the same time completely unexpected and unprepared intracardial shock experience. Within the first year after implantation, 30-50% of patients with an ICD for secondary preventative indications experience such a shock. The average shock application frequency per year (under normal conditions) is about 2.5 shocks. The experience of one or more ICD shocks is significantly associated with a decrease in quality of life. Particularly the experiencing of five or more intracardial shocks approaches the patient's psychological resilience threshold. Partners and relatives of ICD patients are, on the other hand, often helpless with respect to the demands of and stress associated with the ICD technology. In current clinical practice, the involvement of the partners in the treatment of ICD patients is generally a coincidence and is generally not systematic or target-oriented. Improved involvement of relatives can contribute to an improved prognosis. Cardiologists caring for ICD patients should be aware of the specific psychological aspects of ICD technology, integrate these aspects into the guidance and care of patients, and be able to identify and address pathologically negative affects and crises in ICD patients.

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