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Impact of Pacemakers and Implantable Cardioverter Defibrillators on the Psychosocial Functioning of Paediatric Patients

Part of: Electrophysiology Ventricular Septal Defect (VSD)

Published online by Cambridge University Press:  21 October 2020

Ali Dinc Bozat Open the ORCID record for Ali Dinc Bozat [Opens in a new window] ,
Sinem Akgül ,
İlker Ertugrul  and
Tevfik Karagoz
Ali Dinc Bozat*
Affiliation:
Department of Pediatrics, Hacettepe University, Ankara, Turkey
Sinem Akgül
Affiliation:
Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University, Ankara, Turkey
İlker Ertugrul
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
Tevfik Karagoz
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
*
Author for correspondence: Ali Dinc Bozat, Department of Pediatrics, Hacettepe University, Ankara, Turkey. Tel: +905339347308; Fax: +903123118226. E-mail: alidincbozat@hotmail.com
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Abstract

Although implanted cardiac devices improve patients’ physical health, long-term psychosocial effects especially in the paediatric population are still unknown. The aim of this study was to evaluate the psychosocial effects of cardiac devices in a paediatric population.

Pediatric Quality of Life Questionnaire (PedsQoL) was used to evaluate life quality, Connor–Davidson Resilience Scale was used to evaluate resilience and Brief Symptom Inventory was used to evaluate psychiatric symptoms in a paediatric population with cardiac devices.

Seventy-one patients were enrolled in the study. Fifty of them (70.5%) had a cardiac pacemaker and 21 of them (29.5%) had implantable cardioverter defibrillator. When compared to the control group both implantable cardioverter defibrillator and pacemaker using patients had lower quality of life (79.5 ± 12.4 versus 86.7 ± 12.1, p = 0.001) but no difference was observed in resilience and psychological pathologies. Age, gender, family size, and education level had no effect on quality of life. Implantable cardioverter defibrillator bearing patients had higher levels of anxiety than pacemaker patients (0.58 versus 0.30 p = 0.045), and implantable cardioverter defibrillator patients who had received shock in the last year had higher levels of somatisation than the group that did not receive device shock (0.17 versus 0.44 p = 0.022).

In conclusion study showed that cardiac devices have negative effects on the psychosocial health of children. Cardiologist working with these patients should be aware of these pathologies and monitor not only physical health but also psychosocial health too.

Keywords

Quality of lifepacemakerresiliencepsychosocial functioningICD
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 1 , January 2021 , pp. 71 - 76
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Park, MK. Cardiac pacemakers and implantable cardioverter-defibrillators in children. In: Park MK, Salamat M (eds). Park’s Pediatric Cardiology for Practitioners. Elsevier, Philadelphia, PA, 2014: 440–448.Google Scholar
Epstein, AE, DiMarco, JP, Ellenbogen, KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 2008; 117: e350–e408. doi: 10.1161/circualtionaha.108.189742 Google Scholar
Wang, Q, Hay, M, Clarke, D, Menahem, S. The prevalence and predictors of anxiety and depression in adolescents with heart disease. J Pediatr 2012; 161: 943–946. doi: 10.1016/j.jpeds.2012.04.010 CrossRefGoogle ScholarPubMed
Kasmi, L, Calderon, J, Montreuil, M, et al. Neurocognitive and psychological outcomes in adults with dextro-transposition of the great arteries corrected by the arterial switch operation. Ann Thorac Surg 2018; 105: 830–836. doi: 10.1016/j.athoracsur.2017.06.055 CrossRefGoogle ScholarPubMed
Alkan, F, Sertcelik, T, Yalin Sapmaz, S, Eser, E, Coskun, S. Responses of mothers of children with CHD: quality of life, anxiety and depression, parental attitudes, family functionality. Cardiol Young 2017; 27: 1748–1754. doi: 10.1017/s1047951117001184 CrossRefGoogle Scholar
Magyar-Russell, G, Thombs, BD, Cai, JX, et al. The prevalence of anxiety and depression in adults with implantable cardioverter defibrillators: a systematic review. J Psychosomat Res 2011; 71: 223–231. doi: 10.1016/j.jpsychores.2011.02.014 CrossRefGoogle ScholarPubMed
Aydemir, O, Ozmen, E, Kuey, L, et al. Psychiatric morbidity and depressive symptomatology in patients with permanent pacemakers. Pacing Clin Electrophysiol 1997; 20: 1628–1632.10.1111/j.1540-8159.1997.tb03531.xCrossRefGoogle ScholarPubMed
Mlynarska, A, Mlynarski, R, Golba, KS. Influence of frailty on the quality of life patients qualified for pacemaker implantation. J Clin Nurs 2018; 27: 555–560. doi: 10.1111/jocn.13897 CrossRefGoogle ScholarPubMed
Barros, RT, Carvalho, SM, Silva, MA, Borges, JB. Evaluation of patients’ quality of life aspects after cardiac pacemaker implantation. Rev Bras Cir Cardiov 2014; 29: 37–44.CrossRefGoogle ScholarPubMed
Rhodes, AC, Murray, B, Tichnell, C, James, CA, Calkins, H, Sears, SF. Quality of life metrics in arrhythmogenic right ventricular cardiomyopathy patients: the impact of age, shock and sex. Int J Cardiol 2017; 248: 216–220. doi: 10.1016/j.ijcard.2017.08.026 CrossRefGoogle ScholarPubMed
DeMaso, DR, Lauretti, A, Spieth, L, et al. Psychosocial factors and quality of life in children and adolescents with implantable cardioverter-defibrillators. Am J Cardiol 2004; 93: 582–587. doi: 10.1016/j.amjcard.2003.11.022 CrossRefGoogle ScholarPubMed
Webster, G, Panek, KA, Labella, M, et al. Psychiatric functioning and quality of life in young patients with cardiac rhythm devices. Pediatrics 2014; 133: e964–e972. doi: 10.1542/peds.2013-1394 CrossRefGoogle ScholarPubMed
Sapienza, JK, Masten, AS. Understanding and promoting resilience in children and youth. Curr Opin Psychiatry 2011; 24: 267–273. doi: 10.1097/YCO.0b013e32834776a8 CrossRefGoogle ScholarPubMed
Masten, AS. Resilience in children threatened by extreme adversity: frameworks for research, practice, and translational synergy. Dev Psychopathol 2011; 23: 493–506. doi: 10.1017/s0954579411000198 CrossRefGoogle ScholarPubMed
Masten, AS. Resilience in developing systems: progress and promise as the fourth wave rises. Dev Psychopathol 2007; 19: 921–930. doi: 10.1017/s0954579407000442 CrossRefGoogle ScholarPubMed
Masten, AS. Ordinary magic: resilience processes in development. Am Psychol 2001; 56: 227–238.10.1037/0003-066X.56.3.227CrossRefGoogle ScholarPubMed
Cicchetti, D. Resilience under conditions of extreme stress: a multilevel perspective. World Psychiatry 2010; 9: 145–154.10.1002/j.2051-5545.2010.tb00297.xCrossRefGoogle ScholarPubMed
Varni, JW, Seid, M, Kurtin, PS. PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001; 39: 800–812.CrossRefGoogle ScholarPubMed
Ravens-Sieberer, U, Karow, A, Barthel, D, Klasen, F. How to assess quality of life in child and adolescent psychiatry. Dialogues Clin Neurosci 2014; 16: 147–158.Google ScholarPubMed
Uneri, OS, Agaoglu, B, Coskun, A, Memik, NC. Validity and reliability of Pediatric Quality of Life Inventory for 2- to 4-year-old and 5- to 7-year-old Turkish children. Qual Life Res 2008; 17: 307–315. doi: 10.1007/s11136-007-9303-4 CrossRefGoogle ScholarPubMed
Memik, NC, Ağaoğlu, B, Coşkun, A, Üneri, O, Karakaya, I. Çocuklar için yaşam kalitesi ölçeğinin 13–18 yaş ergen formunun geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi 2007; 18: 353–363.Google Scholar
Memik, N, Aǧaoǧlu, B, Coskun, A. The validity and reliability of Pediatric Quality of Life Inventory in 8–12 years old Turkish children. Çocuk ve Gençlik Ruh Sağlığı Dergisi 2008; 15: 353–363.Google Scholar
Connor, KM, Davidson, JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003; 18: 76–82. doi: 10.1002/da.10113 CrossRefGoogle Scholar
Karairmak, O. Establishing the psychometric qualities of the Connor-Davidson Resilience Scale (CD-RISC) using exploratory and confirmatory factor analysis in a trauma survivor sample. Psychiatry Res 2010; 179: 350–356. doi: 10.1016/j.psychres.2009.09.012 CrossRefGoogle Scholar
Derogatis, LR, Melisaratos, N. The Brief Symptom Inventory: an introductory report. Psychol Med 1983; 13: 595–605.CrossRefGoogle Scholar
hisli sahin, N, Batıgün, A. Kisa Semptom Envanteri: Türk gençleri için uyarlanmasi. Türk Psikoloji Dergisi 1994; 9: 44–56.Google Scholar
Pyngottu, A, Werner, H, Lehmann, P, Balmer, C. Health-related quality of life and psychological adjustment of children and adolescents with pacemakers and implantable cardioverter defibrillators: a systematic review. Pediatr Cardiol 2019; 40: 1–16. doi: 10.1007/s00246-018-2038-x CrossRefGoogle ScholarPubMed
Wilmot, I, Cephus, CE, Cassedy, A, Kudel, I, Marino, BS, Jefferies, JL. Health-related quality of life in children with heart failure as perceived by children and parents. Cardiol Young 2016; 26: 885–893. doi: 10.1017/s1047951115001468 CrossRefGoogle ScholarPubMed
Bratt, EL, Luyckx, K, Goossens, E, Budts, W, Moons, P. Patient-reported health in young people with congenital heart disease transitioning to adulthood. J Adolesc Health 2015; 57: 658–665. doi: 10.1016/j.jadohealth.2015.07.021 CrossRefGoogle ScholarPubMed
Qintar, M, George, JJ, Panko, M, et al. A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety. J Interv Card Electrophysiol 2015; 43: 65–75. doi: 10.1007/s10840-015-9990-7 CrossRefGoogle ScholarPubMed
Kikkenborg Berg, S, Caspar Thygesen, L, Hastrup Svendsen, J, Vinggaard Christensen, A, Zwisler, AD. Anxiety predicts mortality in ICD patients: results from the cross-sectional national CopenHeartICD survey with register follow-up. Pacing Clin Electrophysiol 2014; 37: 1641–1650. doi: 10.1111/pace.12490 Google ScholarPubMed
Al Busaidi, ZQ. The concept of somatisation: a cross-cultural perspective. Sultan Qaboos Univ Med J 2010; 10: 180–186.Google ScholarPubMed
Garralda, ME. Somatisation in children. J Child Psychol Psychiatry 1996; 37: 13–33. doi: 10.1111/j.1469-7610.1996.tb01378.x CrossRefGoogle ScholarPubMed
Waddell-Smith, KE, Ertresvaag, KN, Li, J, et al. Physical and psychological consequences of left cardiac sympathetic denervation in long-QT syndrome and catecholaminergic polymorphic ventricular tachycardia. Circ Arrhythm Electrophysiol 2015; 8: 1151–1158. doi: 10.1161/circep.115.003159 CrossRefGoogle ScholarPubMed
Hintsa, T, Jokela, M, Elovainio, M, et al. Stressful life events and depressive symptoms among symptomatic long QT syndrome patients. J Health Psychol 2016; 21: 505–512. doi: 10.1177/1359105314530450 CrossRefGoogle ScholarPubMed
Hamang, A, Eide, GE, Rokne, B, Nordin, K, Bjorvatn, C, Øyen, N. Predictors of heart-focused anxiety in patients undergoing genetic investigation and counseling of long QT syndrome or hypertrophic cardiomyopathy: a one year follow-up. J Genet Counsel 2012; 21: 72–84. doi: 10.1007/s10897-011-9393-6 CrossRefGoogle ScholarPubMed
Evers, AW, Kraaimaat, FW, Geenen, R, Jacobs, JW, Bijlsma, JW. Stress-vulnerability factors as long-term predictors of disease activity in early rheumatoid arthritis. J Psychosom Res 2003; 55: 293–302.CrossRefGoogle ScholarPubMed
DeMaso, DR, Spratt, EG, Vaughan, BL, D’Angelo, EJ, Van der Feen, JR, Walsh, E. Psychological functioning in children and adolescents undergoing radiofrequency catheter ablation. Psychosomatics 2000; 41: 134–139.CrossRefGoogle ScholarPubMed
Noll, RB, Vannatta, K, Koontz, K, Kalinyak, K, Bukowski, WM, Davies, WH. Peer relationships and emotional well-being of youngsters with sickle cell disease. Child Develop 1996; 67: 423–436.Google ScholarPubMed
Moon, JR, Song, J, Huh, J, et al. The relationship between parental rearing behavior, resilience, and depressive symptoms in adolescents with congenital heart disease. Front Cardiovasc Med 2017; 4: 55–55. doi: 10.3389/fcvm.2017.00055 CrossRefGoogle ScholarPubMed