İmplantabl Kardiyoverter-Defibrilatör Takılan Hastalarda Şok Tedavisinin Hasta Sağlık İlişkili Yaşam Kalitesine Etkisi

GİRİŞ ve AMAÇ: İmplantabl kardiyoverterdefibrilatörler (İKD' ler) ani kardiyak ölümün önüne geçerek, mortaliteyi etkin bir şekilde azaltmaktadır. Bununla birlikte, uygun ya da uygunsuz, İKD şoklaması, özellikle aşılması zor psikolojik süreçlere yol açar ve de kötü yaşam kalitesi ile ilişkilidir. Çalışmamızda, şoklama ile sağlık ilişkili yaşam kalitesi arasındaki ilişkiyi göstermeyi amaçladık. YÖNTEM ve GEREÇLER: Tek, iki ya da üç odacıklı (Kardiyak resenkronizasyon tedavisi-defibrilatör (KRTD) ) İKD implante edilmiş hastalar dahil edildi. Kliniğimize rutin cihaz kontrolü için başvuran hastalar, başvuruda ve 12. ayda Kısa Form-36 sağlık anketini tamamladılar. Klinik parametreler ve cihaz ölçümleri kayıt altına alındı. BULGULAR: Yaş ortalaması 62±12 olan, 161'i (74%) erkek toplam 217 hasta çalışmaya dahil edildi. Takiplerde ölüm gerçekleşen 10 (4.6%) hasta çalışma dışına alındı. Kalan 207 hastanın yaş ortalaması 62±12 idi. Takiplerde 26 (12.6%) hasta şoklama tedavisi aldı. 16 hasta uygun; 10 hasta is uygunsuz şok tedavisi aldı. 18 hastada 2 ya da daha fazla şok tedavisi saptandı. Sağlık durumu parametreleri, şoklama tedavisi gören hastalarda daha kötü saptandı. TARTIŞMA ve SONUÇ: İKD şoklama tedavisi, kötüleşmiş hasta yaşam kalitesi ile ilişkilidir. Dolayısıyla, rutin psikolojik durum değerlendirmesi, İKD hastalarının klinik takiplerine dahil edilmelidir.

The Effect of Shock Therapies on Health-Related Quality of Life in Patients with Implantable Cardioverter-Defibrrillator

INTRODUCTION: Implantable cardioverterdefibrillators (ICDs) reduce mortality from suddencardiac death (SCD) effectively. However, ICDdischarge, whether appropriate or inappropriate,represents a particularly challenging psychologicalevent and is associated with poor quality of life (QoL).We aimed to investigate the association of shock and thehealth-related QoL.METHODS: Patients implanted with either single, dualchamber ICDs or CRT-D devices were included. Whenthey presented at our clinic for regular device follow-up,they completed the Short-Form Health Survey 36 (SF-36) at baseline and 12 months. Clinical parameters anddevice measurements were recorded.RESULTS: A total of 217 patients, including 161 (74%)males with a mean age of 62±12 years, were included inthe study. We excluded 10 (4.6%) patients that diedduring the follow-up. The mean age of the remaining207 patients (53 female and 154 male) was 62±12 years.During the follow-up, 26 (12.6%) patients experiencedshock therapy. Six-teen of them had appropriate and 10of them had inappropriate shocks. Two or more shockswere delivered in 18 (8.7%) patients. Health statuspatterns were poor in patients received shock therapiesduring follow-up period.DISCUSSION and CONCLUSION: ICD shocks wereassociated with impaired health- related QoL. So,routine consideration of psychosocial situation needs tobe integrated into the clinical care of ICD patients.

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