Patient Expectations From Implantable Defibrillators to Prevent Death in Heart Failure

JOURNAL OF CARDIAC FAILURE

卷:16

Article

Stewart, Garrick C.¹  Weintraub, Joanne R.¹  Pratibhu, Parakash P.¹  Semigran, Marc J.²  Camuso, Janice M.²  Brooks, Kimberly¹  Tsang, Sui W.³  Anello, Mary Susan¹  Nguyen, Viviane T.¹  Lewis, Eldrin F.¹  Nohria, Anju¹  Desai, Akshay S.¹  Givertz, Michael M.¹  Stevenson, Lynne W.¹ 

[1] Brigham & Womens Hosp, Div Cardiovasc Med, Boston, MA 02115 USA

[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Boston, MA USA

[3] Yale Univ, Sch Epidemiol & Publ Hlth, Dept Biostat, New Haven, CT USA

关键词: Implantable defibrillators;    heart failure;    sudden death;    cardiomyopathy;   

DOI  :  10.1016/j.cardfail.2009.09.003

来源: Elsevier

【 摘 要 】

Background: Indications for implantable cardioverter-defibrillators (ICDs) in heart failure (HF) are expanding and may include more than 1 million patients. This study examined patient expectations from ICDs for primary prevention of sudden death in HF. Methods and Results: Study participants (n = 105) had an EF <35% and symptomatic HF, without history of ventricular tachycardia/fibrillation or syncope. Subjects completed a written survey about perceived ICD benefits, survival expectations, and circumstances under which they might deactivate defibrillation. Mean age was 58, LVEF 21%, 40% were New York Heart Association Class and 65% already had a primary prevention ICD. Most patients anticipated more than 10 years survival despite symptomatic HF. Nearly 54% expected an ICD to save >= 50 lives per 100 during 5 years. ICD recipients expressed more confidence that the device would save their own lives compared with those without an ICD (P < .001). Despite understanding the ease of deactivation, 70% of ICD recipients indicated they would keep the ICD on even if dying of cancer, 55% even if having daily shocks, and none would inactivate defibrillation even if suffering constant dyspnea at rest. Conclusions: HE patients anticipate long survival, overestimate survival benefits conferred by ICDs, and express reluctance to deactivate their devices even for end-stage disease. (J Cardiac Fail 2010:16:106-113)

【 授权许可】

Free