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Pacing Clin Electrophysiol. 2011 Mar;34(3):348-53. doi: 10.1111/j.1540-8159.2010.02971.x. Epub 2010 Nov 15.

Recollection of pain due to inappropriate versus appropriate implantable cardioverter-defibrillator shocks.

Author information

1
Cardiac Electrophysiology Section, University of California, San Francisco, California, USA. marcusg@medicine.ucsf.edu

Abstract

BACKGROUND:

Although inappropriate shocks are known to be an important consequence of implantable cardioverter-defibrillators (ICDs), the subjective experience of pain intensity perceived by those receiving inappropriate versus appropriate shocks has not previously been examined.

METHODS:

One hundred ICD patients underwent a standardized interview by an investigator blinded to the clinical history. Patients with a previous ICD shock were asked to describe the intensity of the associated pain on a standard 0-10 scale (10 being the worst pain they had ever experienced). Medical charts were then examined for any history of inappropriate and/or appropriate ICD discharges.

RESULTS:

Thirty-five of the 100 patients had a record of at least one ICD shock, and 17 had experienced at least one inappropriate shock. Those with a history of an inappropriate shock described a significantly higher median pain scale (9, interquartile range [IQR] 8-10) compared to those with a history of only appropriate shocks (median 4, IQR 2-8, P = 0.0011). In multivariable analysis, a history of an inappropriate shock was the only predictor statistically significantly associated with an increase in shock pain: the pain scale for those with inappropriate shocks was higher by 2.8 points on average after multivariable adjustment (95% confidence interval 0.29-5, P = 0.030). Eighteen patients had considered having their device deactivated, and a history of an inappropriate shock was the only factor independently associated with this consideration.

CONCLUSIONS:

Compared to those who have received only appropriate shocks, inappropriate ICD shocks are associated with a recollection of greater pain and consideration of device inactivation.

PMID:
21077915
PMCID:
PMC3057533
DOI:
10.1111/j.1540-8159.2010.02971.x
[Indexed for MEDLINE]
Free PMC Article

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