Pacemakers make heart patients anxious and depressed

Twenty-five per cent of patients fitted with pacemakers suffer from anxiety after the surgery and 15 per cent develop depression. Those are the findings of a large research project supported by TrygFonden

The research project evaluated the patients’ physical and mental wellbeing, following surgery--as well as sexual activity, the effect of intense rehabilitation on both the body and mind, and how these varied according to gender.

Those who were diagnosed with anxiety also experienced higher mortality rates, up to four times higher than patients who were not anxious.

"The number of people who are anxious and whose mortality is effected is really dramatic,” says lead-author Selina Kikkenborg Berg, from the University of Copenhagen and Southern Denmark University.

“We know that anxiety is very debilitating--and an increased risk of dying provides a real incentive to do something about it," she says.

Heart patients are a vulnerable group

The researchers sent questionnaires out to cardiovascular patients who had been fitted with a pacemaker within the past 6 to 12 months. A total of 358 patients responded.

They revealed that both anxiety and depression is common among the patients, and offered a snapshot into the patients’ own perception of their physical and mental health.

Co-author Professor Ann-Dorthe Zwisler, centre manager of the Research Centre for Rehabilitation and Palliative Care at the University of Southern Denmark, says the results underline the importance of providing the right support for pacemaker patients.

"This type of intervention, where patients have a say in how they are doing, sends an important message,” says Zwisler.

“It’s something we mustn’t forget. We’re so busy keeping patients alive, but we must also remember that they have to live the best possible life [after treatment]," she says.

Professor Gunnar Gislason, director of the Hearth Foundation and consultant at Gentofte Hospital, the University of Copenhagen, Denmark, agrees.

He was not involved with the research but has followed the group’s progress.

Gislason describes the patients as a particularly vulnerable group of people, many of which have a very tough time during their recovery.

"We have to deal with these anxiety problems. But we lack the knowledge of how best to do so," he says.

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Read the Danish version of this story on Videnskab.dk
 

Translated by: Catherine Jex

Scientific links

• Comprehensive cardiac rehabilitation improves outcome for patients with implantable cardioverter defibrillator. Findings from the COPE-ICD randomised clinical trial, European Journal of Cardiovascular Nursing 2014, DOI: 10.1177/1474515114521920
• Effect of Cardiac Rehabilitation in Patients with ICD: Are Gender Differences Present? Results from the COPE-ICD Trial, Pacing and Clinical Electrophysiology 2015, DOI: 10.1111/pace.12507
• Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes: findings from the COPE-ICD randomized controlled trial, Journal of Rehabilitation Medicine 2015, DOI: 10.2340/16501977-1920
• Physical activity in primary versus secondary prevention indication implantable cardioverter defibrillator recipients 6-12 months after implantation - a cross-sectional study with register follow up, Archives of Physical Medicine and Rehabilitation 2015
• Phantom shocks in patients with implantable cardioverter defibrillator: results from a randomized rehabilitation trial (COPE-ICD), Europace 2013, DOI: 10.1093/europace/eut087
• Sexual concerns and practices after ICD implantation: findings of the COPE-ICD rehabilitation trial, European Journal of Cardiovascular Nursing 2013, DOI: 10.1177/1474515112473528

External links

• Selina Kikkenborg Berg
• Gunnar Gislason
• Ann-Dorthe Zwisler

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