Susanne S. Pedersen

Psychological Intervention Following Implantation of an Implantable Defibrillator: A Review and Future Recommendations

Background: The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current evidence on the efficacy of psychological intervention in ICD patients and recommendations for future research.

Gender Differences in Anxiety and Concerns about the Cardioverter Defibrillator

Background: Little is known about gender differences in the response to implantable cardioverter defibrillator (ICD) therapy. We compared female and male ICD patients on anxiety, depression, health‐related quality of life (HRQL), ICD concerns, and ICD acceptance.

Correlates of Patient Acceptance of the Cardioverter Defibrillator: Cross‐Validation of the Florida Patient Acceptance Survey in Danish Patients

Background: Device acceptance may comprise one of the keys to identifying implantable cardioverter defibrillator (ICD) patients at risk for adverse health outcomes in clinical practice. We examined (1) the validity and reliability of the Florida Patient Acceptance Survey (FPAS) and (2) correlates of device acceptance in a large sample of Danish patients.

Type D patients report poorer health status prior to and after cardiac rehabilitation compared to non-type D patients

BackgroundType D personality is an emerging risk factor in coronary artery disease (CAD). Cardiac rehabilitation (CR) improves outcomes, but little is known about the effects of CR on Type D patients.PurposeWe examined (1) variability in Type D caseness following CR, (2) Type D as a determinant of health status, and (3) the clinical relevance of Type D as a determinant of health status compared to cardiac history.MethodsCAD patients (nu2009=u2009368) participating in CR completed the Type D Scale, the Short-Form Health Survey 36 pre- and post-CR, and the Hospital Anxiety and Depression Scale pre-CR, to assess health status and depressive and anxious symptomatology, respectively.ResultsThe prevalence of Type D decreased from 26.6% to 20.7% (pu2009=u20090.012) following CR, but Type D caseness remained stable in 81% of patients. Health status significantly improved following CR [F(1,359)u2009=u200917.48, pu2009<u20090.001], adjusting for demographic and clinical factors and anxious and depressive symptoms. Type D patients reported poorer health status [F(1,359)u2009=u200910.40, pu2009=u20090.001], with the effect of Type D being stable over time [F(1,359)u2009=u20090.49, pu2009=u20090.48]. Patients with a cardiac history benefited less from CR [F(1,359)u2009=u20095.76, pu2009=u20090.02]. The influence of Type D on health status was larger compared to that for cardiac history, as indicated by Cohen’s effect size index.ConclusionsType D patients reported poorer health status compared to non-Type D patients pre- and post-CR. In the majority of patients, CR did not change Type D caseness, with Type D being associated with a stable and clinically relevant effect on outcome. These high-risk patients should be identified in clinical practice and may require adjunctive interventions.

Clustering of poor device acceptance and Type D personality is associated with increased distress in Danish cardioverter-defibrillator patients

Background: Psychosocial risk factors tend to cluster together within individuals, likely enhancing the risk of adverse health outcomes. We examined (1) the influence of clustering of poor device acceptance and Type D personality on anxiety and depressive symptoms, and (2) the demographic and clinical determinants of patients with clustering, in a large cohort of Danish implantable cardioverter defibrillator (ICD) patients.

Response to Cardiac Resynchronization Therapy: Is It Time to Expand the Criteria?

Background: Cardiac resynchronization therapy (CRT) is a promising treatment for a subgroup of patients with advanced congestive heart failure and a prolonged QRS interval. Despite the majority of patients benefiting from CRT, 10–40% of patients do not respond to this treatment and are labeled as nonresponders. Given that there is a lack of consensus on how to define response to CRT, the purpose of this viewpoint is to discuss currently used definitions and their shortcomings, and to provide recommendations as to how an expansion of the criteria for CRT response may be useful to clinicians.

Health Status in Patients Treated with Cardiac Resynchronization Therapy: Modulating Effects of Personality

Background: Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated with CRT improved in patient‐centered outcomes and functional capacity, and (2) whether personality traits exert a stable effect on these outcomes over two months.