Symptomatic Heart Failure Is the Most Important Predictor of Impaired Quality of Life and Depression in Outpatients with Implantable Cardioverter Defibrillators

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Purpose: Psychological aspects of living with an implantable cardioverter defibrillators (ICD) should also be considered, because the full benefits of ICD therapy can only be achieved if the patient's quality of life (QOL) and emotional well-being are preserved. This study aimed to determine the predictors of impaired QOL and depression in the ICD patients. Methods: Consecutive patients who had undergone ICD implantation (n=179) completed a set of validated questionnaires, including Short Form-8 Health Survey assessed QOL, Beck Depression Inventory assessed depression, and State-trait anxiety inventory assessed anxiety. Clinical characteristics and treatment were also examined. Multiple linear regression analysis was performed to compare predictors of QOL and psychological distress. Results: Mean age was 60.5 years. Females consisted 19%. In multivariate linear regression analysis, symptomatic heart failure (HF) was the most important predictor of impaired physical and mental component of QOL [Physical component; β-coefficient=－3.4, p<0.001, mental component: β-coefficient=－2.9, p=0.03]. Symptomatic HF was also the most dominant associated with depression [β-coefficient=－5.9, p<0.001]. ICD shocks were not associated with depression and QOL. Conclusions: These results suggest that focus should be directed towards improving the QOL and reducing depression in subgroup patients, particularly those with symptomatic HF.