Here’s what the American Heart Association (AHA) researchers found after reviewing all the evidence from rigorously reviewed studies:

  • Approximately 20 percent of ICD patients suffer from clinically significant psychological distress, according to one recent systematic review spanning 45 studies and more than 5,000 patients.
  • Thirteen to 38 percent of ICD patients suffer from anxiety. About 54 percent of patients who were anxious before implantation continued to suffer from chronic anxiety more than one year after receiving an ICD.
  • Ten to 46 percent of ICD patients are depressed.
  • Twenty-one percent of ICD patients have posttraumatic stress disorder (PTSD) symptoms, likely due to experiencing multiple shocks or surviving sudden cardiac arrest. One year after implantation, the amount dropped to about 13 percent. PTSD can directly affect patient outcomes: In one study, patients with the disorder had an increased risk of death.

The studies featured in the statement had mixed results when pinpointing common factors among emotionally distressed patients, and more research is needed in this area. However, the researchers identified some trends, suggesting that people who may experience a greater degree of distress include those who:

  • Have experienced more than five shocks
  • Have other chronic illnesses
  • Have a "type D" personality (negative, anxiety-prone)
  • Lack understanding of the device and the underlying disease
  • Are younger than 50 years old
  • Are female
  • Are single
  • Perceive a lack of social support

Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Publication Review By: the Editorial Staff at

Published: 10 Jul 2013

Last Modified: 08 Sep 2015