Fears and distress in patients with ICDs can be alleviated with help from doctors and other specialists. To help patients cope with living with an ICD, the American Heart Association (AHA) recommends that patients be adequately counseled before implantation as to what to expect from an ICD and, afterward, undergo routine screening and appropriate treatment for depression, anxiety and PTSD.
If you are considering, or already have, an ICD, make sure you and your loved ones have a full understanding of:
- The ICD's benefits and limitations
- Your disease's course and your general prognosis
- The impact the ICD will have on your lifestyle, such as driving, travel and physical and sexual activity
- Battery longevity and device replacement
- What a shock means and what to expect
- What to do in the case of a shock (called a shock plan)
- How to handle a device recall
- End-of-life care goals, including device deactivation
If you have an ICD and find yourself losing interest or pleasure in doing things, and are feeling down, depressed or hopeless, consult your doctor. These are all potential signs of psychological distress.
Consider relaxation therapy or cognitive behavioral therapy to help alleviate anxiety. One study found that patients who participated in educational sessions and were taught skills to help them cope with anxiety had an improved ability to adjust to living with their device. You may also find it helpful to talk with someone who has personal experience living with an ICD
. If you're bothered by shocks, your doctor may be able to reduce or eliminate them by prescribing anti-arrhythmic drugs. Your ICD settings may also need to be reprogrammed. Be sure to contact your doctor every time you experience a shock. If a shock is accompanied by chest pain, shortness of breath or a rapid heartbeator if you have a cluster of shocksgo to an emergency room.
Finally, regular physical activity or cardiac rehabilitation after implantation can also help. Studies show that both appear to improve quality of life and reduce anxiety among ICD patients.
Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50