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Aging Clin Exp Res. 2018 Dec 14. doi: 10.1007/s40520-018-1088-5. [Epub ahead of print]

The influence of age on the psychological profile of patients with cardiac implantable electronic devices: results from the Italian population in a multicenter study conducted by the European Heart Rhythm Association.

Author information

1
Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit, University of Florence and AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy. stefano.fumagalli@unifi.it.
2
Electrophysiology Laboratory, University of Florence and AOU Careggi, Florence, Italy.
3
Oslo University Hospital, Oslo, Norway.
4
University of Belgrade, Belgrade, Serbia.
5
Department of Health Sciences, Department of Health Professions, University of Florence and AOU Careggi, Florence, Italy.
6
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
7
Montevergine Cardiology Clinic, Mercogliano, Italy.
8
Clinical Institute Humanitas Gavazzeni, Bergamo, Italy.
9
Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit, University of Florence and AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy.
10
Silesian Center for Heart Diseases, Zabrze, Poland.
11
Cardiology Department, Clinique Pasteur, Toulouse, France.
12
Department of Electrophysiology, Heart Center of Leipzig, Leipzig, Germany.

Abstract

BACKGROUND:

Cardiac implantable electronic devices (CIEDs) are widely used to treat bradyarrhythmias or improve the prognosis of patients with heart failure (HF).

AIMS:

To evaluate age-related (≤ 75 vs. > 75 years) attitudes, worries, psychological effects and needs in an Italian CIEDs population.

METHODS:

Patients attending their periodical ambulatory evaluation received a questionnaire conceived by the European Heart Rhythm Association Scientific Initiatives Committee as part of a multicenter, multinational snapshot survey. Seven countries participated in the study, and 1646 replies were collected. Of these, 437 (27%) were from Italy. Present results refer to the Italian population only. CIEDs were stratified into devices to treat bradycardia or HF.

RESULTS:

The use of CIEDs was more common in advanced age. Older patients needed less information about CIEDs than younger ones (p = 0.044), who would prefer to be better informed about CIEDs-related consequences on psychologic profile (p = 0.045), physical (p < 0.001) and sexual (p < 0.001) activities, and driving limitations (p = 0.003). When compared to older subjects, younger individuals experienced more difficulties (p = 0.035), especially in their professional (p < 0.001) and private life (p = 0.033), feeling their existence was limited by the device (p < 0.001). Conversely, quality of life (HRQL) more often improved in the elderly (p = 0.001). Information about what to do with CIEDs at the end of life is scant independently of age.

CONCLUSIONS:

HRQL after CIEDs implantation improves more frequently in older patients, while the psychological burden of CIEDs is usually higher in younger patients. End of life issues are seldom discussed.

KEYWORDS:

CRT; Cardiac implantable electronic devices; Elderly; End-of-life issues; ICD; Quality of life

PMID:
30552563
DOI:
10.1007/s40520-018-1088-5

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