In the United States over 350,000 individuals die annually from sudden cardiac arrest due to ventricular tachyarrhythmias. Numerous large-scale clinical trials have consistently demonstrated that implantable cardioverter defibrillators (ICDs) reduce mortality among appropriately selected patients who have survived an episode of potentially life-threatening ventricular arrhythmia (secondary prevention) or are at risk for ventricular arrhythmia (primary prevention). Despite the demonstrated success of the ICD, many patients often experience unique physical, emotional, and psychosocial needs that can directly impact their overall quality of life (QOL). The most common psychological disturbances following ICD implantation include stress, anxiety, depression, or fear, typical of any chronic illness. Additionally, ICDs impose unique emotional pressures relating to altered body image, painful shocks, and the possibility of hardware failure. The random nature of shocks commonly induces feelings of isolation and powerlessness and the experience of shocks is directly linked to poor QOL outcomes. Lifestyle changes, such as restrictions on driving, eligibility for employment, marital and social relationships, sexual intimacy, or participation in recreational activities can significantly affect the ICD patient’s psychological and emotional well-being. The purpose of this article is to review the QOL data from several large-scale clinical trials of ICD patients as well as to examine specific QOL issues such as driving restrictions, occupational, and recreational concerns.
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Electrophysiology and Device Therapy| July 01 2004
Quality of Life Issues in Patients With Implantable Cardioverter Defibrillators: Driving, Occupation, and Recreation
Julie B. Shea, MS, RNCS
From the Cardiovascular Division, Brigham and Women’s Hospital, Boston, Mass.
Reprint requests to Ms Shea, Brigham and Women’s Hospital, Cardiovascular Division, 75 Francis St, Boston, MA 02115 (firstname.lastname@example.org).
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AACN Adv Crit Care (2004) 15 (3): 478–489.
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Julie B. Shea; Quality of Life Issues in Patients With Implantable Cardioverter Defibrillators: Driving, Occupation, and Recreation. AACN Adv Crit Care 1 July 2004; 15 (3): 478–489. doi:
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