The assessment of stress reactions of patients with implanted defibrillators

Abstract

Background. Although they save life, implantable defibrillators havepsychological side effects and increase the number of patients whoexperience anxiety, depressive symptoms and, in extreme cases,post-traumatic stress disorder (PTSD). Escalation of PTSD symptomsdepends on patients' ability to cope with stress.Objectives. The aim of this study was to assess the reactions ofpatients after defibrillator implantation, and their ways to cope withstress, as well as to analyze the relationship between the ways ofcoping with stress and PTSD symptoms.Material and methods. The study was conducted using the Mini-Cope, theImpact of Event Scale-Revised (IES-R), and the author's questionnaire.It involved 111 patients with implanted defibrillators at the mean ageof 60 years, including 88 (79.3%) men. The majority of the patients hadsecondary education -38 (34.2%) and were married -85 (76.6%). 51(45.9%) were one year after defibrillator implantation.Results. It was demonstrated that 49 (44.1%) of the surveyedexperienced intracardiac discharges, out of whom 8 (17.1%) went throughan `electrical storm'. This group obtained higher PTSD scores in allthree IES-R domains comparing to those without implanted defibrillators.The most common strategy to cope with stress was acceptance of thesituation and searching for emotional support.Conclusions. 1. Intracardiac discharges are the vital problem ofpatients after defibrillator implantation. 2. Searching for emotionalsupport and acceptance of the situation are the most common strategiesto cope with stress. 3. There is a relationship between PTSD symptomsoccurring in patients after implantation of a defibrillator and theirstrategies to cope with stress.