Neuropsychological functioning after implantable cardioverter-defibrillator surgery

Abstract

Basic philosophy of medical practice is to preserve life around the globe irrespective of culture and civilization. But the perception and preference of life varies from person to person with respect to quality and span of life. This historical perspective to human life is in concordance to implantable cardiovertor-defibrillators (ICDs) i.e. an invention which has revolutionized the care of patients at risk of life threatening arrhythmias. Although, the evidence of the superiority of after implantable cardioverter- defibrillators (AICDs) over medications in overcoming the ventricular arrhythmias is beyond the scope of this chapter, yet the studies carried over the last decade strongly supports this choice. This chapter establishes new visionary approach for the new era demands. It consolidate new and Intelligent conceptualization for proper perspective and management options for the newly emerging ICD subjects problems and complaints. Smart anticipation of ICD subjects psychosocial and cognitive difficulties based in previous experience, as adjunct to optimizing their rhythm control will be discussed with global perspective aiming toward treating rhythm disorder in the human beings within the physical and biological diversities and cosmos around them. This chapter is a concise scientific back up for all those working in rhythm management and ICD to support them making critical decisions in the case of emergency situation, looks into the cerebral injury in ICD patients, providing knowledge in prevalence and impact of psychological distress in (ICD) patients, with special focus in PTSD in ICD. Quality of Life (QOL) in ICD patients has been given special attention. The new perspective correlating anxiety, depression and autonomic dysfunction and the viscous cycle for shock continuum as well as the benefits of spiritual well being has been discussed. The newly documented relation of solar and geomagnetic activity (SGA) to human heart rhythm and the sensitivity of the autonomic nervous system to SGA is also discussed. Novel preventive and therapeutic approaches has been discussed. Awareness of the magnitude of psychophysiological distress in ICD patients as a very important step in patients overall management was given concern. The intelligent life style using non pharmacological modalities to prevent ventricular arrhythmias including device programming, cardiac rehabilitation and the intelligent idea of sparing shock with positive emotion illustrating the beneficial outcome of cardiac coherence are discussed. Special emphasis has been given to Cognitive behavioral therapy (CBT) and the increasing weight of evidence of its favorable psychophysiological out come in ICD patients. Acute and long term pharmacological treatment has been mentioned. Finally future directions for the new era related to Technical aspects of the device and System NeuroPsychoBiological approach and The new NeuroPsychoBiological Perspective: from Genes to Galaxies and Neurobiology of PTSD as well as special statement in Transcranial Magnetic Stimulation in Post-Traumatic Stress Disorder has been discussed.