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Title: Factors associated with implantable cardioverter defibrillator (ICD) interventions and their effect on psychological functioning and quality of life
Author: Monk, Vivienne Alexandra
ISNI:       0000 0004 2730 0249
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2012
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The Implantable Cardioverter Defibrillator (ICD) monitors heart rate and intervenes to treat cardiac arrhythmias by electrical shock or pacing. There is evidence that that the number and type of ICD interventions can adversely affect psychological functioning and reduce quality of life and that this may differ between the sexes. Part I focused on ICD interventions and related factors in 726 patients at 9 London hospitals. Results showed that age, sex and ejection fraction were not significantly related to the number of ICD interventions. Evidence was found for both a circadian and circannual distribution of ICD interventions, with peaks occurring between 8am-12pm and in December/January respectively. Part 11 was based on 309 patients from St George's Hospital. It investigated the hypothesis that both ICD interventions and sex would affect psychological functioning and quality of life. The results showed that the type of ICD intervention did not lead to any statistically significant differences in anxiety, anger, depression or any aspect of reduced quality of life. However females scored significantly higher than males on ICD concerns, anxiety and depression and mental health (p<0.05). In regression analysis older age, left ventricular function and total interventions per patient were significantly associated with physical quality of life (p=0.002) and higher scores on depression and trait anxiety were significantly associated with mental quality of life (p<0.05). Part III investigated the stability of these measures after one year in a subgroup of 136 patients. At the follow-up, patients had significantly higher scores on state depression (p=0.03). On the SF-36 there were significantly lower scores on bodily pain, physical functioning and the physical component summary score (p<0.05). In summary, the evidence from the present study shows that psychological functioning and quality of life differences were related to sex rather than the number or type of ICD interventions
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available