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Implantable Cardioverter-Defibrillators and Patient-Reported Outcomes in Adults with Congenital Heart Disease: an International Study
Université de Montréal, Montreal Heart Institute, Montreal, Canada (CAN).
Université de Montréal, Montreal Heart Institute, Montreal, Canada (CAN).
Université de Montréal, Montreal Heart Institute, Montreal, Canada (CAN).
KU Leuven Department of Public Health and Primary Care; University of Leuven, Leuven, Belgium (BEL).
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2020 (English)In: Heart Rhythm, ISSN 1547-5271, E-ISSN 1556-3871, Vol. 17, no 5, p. 768-776Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are increasingly used to prevent sudden deaths in the growing population of adults with congenital heart disease (CHD). Yet, little is known about their impact on patient-reported outcomes (PROs).

OBJECTIVE: We assessed and compared PROs in adults with CHD with and without ICDs.

METHODS: A propensity-based matching weight analysis was conducted to evaluate PROs in an international cross-sectional study of adults with CHD from 15 countries across 5 continents.

RESULTS: A total of 3,188 patients were included: 107 with ICDs and 3,081 weight-matched controls without ICDs. ICD recipients averaged 40.1±12.4 years of age, with >95% having moderate or complex CHD. Defibrillators were implanted for primary and secondary prevention in 38.3% and 61.7%, respectively. Perceived health status, psychological distress, sense of coherence, and health behaviours did not differ significantly in patients with and without ICDs. However, ICD recipients had a more threatening view of their illness (relative % difference 8.56, P=0.011). Those with secondary compared to primary prevention indications had a significantly lower quality of life score (linear analogue scale 72.0±23.1 versus 79.2±13.0, P=0.047). Marked geographic variations were observed. Overall sense of well-being, assessed by a summary score that combines various PROs, was significantly lower in ICD recipients (versus controls) from Switzerland, Argentina, Taiwan, and USA.

CONCLUSIONS: In an international cohort of adults with CHD, ICDs were associated with a more threatening illness perception, with a lower quality of life in those with secondary compared to primary prevention indications. However, marked geographic variability in PROs was observed.

Place, publisher, year, edition, pages
2020. Vol. 17, no 5, p. 768-776
Keywords [en]
adult congenital heart disease, implantable cardioverter-defibrillator, patient-reported outcomes, quality of life, sudden cardiac death
National Category
Cardiac and Cardiovascular Systems
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-14752DOI: 10.1016/j.hrthm.2019.11.026ISI: 000531537700016PubMedID: 31790832Scopus ID: 2-s2.0-85079839192OAI: oai:DiVA.org:hv-14752DiVA, id: diva2:1396171
Funder
Swedish Heart Lung Foundation, 20130607
Note

Funders:Research Fund-KU Leuven (Leuven, Belgium) [OT/11/033];Cardiac Children's Foundation (Taiwan) [CCF2013_02]

Available from: 2020-02-25 Created: 2020-02-25 Last updated: 2021-04-24Bibliographically approved

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