Advertisement

Click here for more guidelines.

 
 




CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2009; 54:531-537, doi:10.1016/j.jacc.2009.04.043
© 2009 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by van den Broek, K. C.
Right arrow Articles by Denollet, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by van den Broek, K. C.
Right arrow Articles by Denollet, J.
Related Collections
Right arrowRelated Article

CLINICAL RESEARCH: HEART RHYTHM DISORDER

Risk of Ventricular Arrhythmia After Implantable Defibrillator Treatment in Anxious Type D Patients

Krista C. van den Broek, PhD*,*, Ivan Nyklícek, PhD*, Pepijn H. van der Voort, MD{dagger}, Marco Alings, MD, PhD{ddagger}, Albert Meijer, MD, PhD{dagger} and Johan Denollet, PhD*

* CoRPS (Center of Research on Psychology in Somatic diseases), Tilburg University, Tilburg, the Netherlands
{dagger} Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
{ddagger} Department of Cardiology, Amphia Hospital, Breda, the Netherlands

Manuscript received February 9, 2009; revised manuscript received March 30, 2009, accepted April 26, 2009.

* Reprint requests and correspondence: Dr. Krista C. van den Broek, CoRPS, Tilburg University, Department of Medical Psychology, Room P612, P.O. Box 90153, 5000 LE Tilburg, the Netherlands (Email: CvdBroek{at}uvt.nl).

Objectives: We sought to examine the combination of adverse psychological factors (anxiety, depression, and distressed or Type D personality) as a predictor of ventricular arrhythmias in patients with implantable cardioverter-defibrillators (ICDs).

Background: Little is known about the role of psychological factors and their clustering in the occurrence of life-threatening arrhythmias.

Methods: In this prospective study, 391 patients with an ICD (81% men, age 62.3 ± 10.4 years) completed anxiety, depression, and Type D personality scales at the time of implantation. The end point was occurrence of ventricular arrhythmia, defined as appropriate ICD therapies, in the first year after implantation.

Results: Ventricular arrhythmias occurred in 19% (n = 75) of patients. Increased symptoms of depression (p = 0.81) or anxiety (p = 0.31) did not predict arrhythmias. However, anxious patients with a Type D personality had a significantly increased rate of ventricular arrhythmias (21 of 71; 29.6%) as compared with other ICD patients (54 of 320; 16.9%; hazard ratio [HR]: 1.89; 95% confidence interval [CI]: 1.14 to 3.13; p = 0.013). When controlled for the effects of sex, age, ischemic etiology, left ventricular dysfunction, prolonged QRS duration, and medication, anxious Type D patients (HR: 1.72; 95% CI: 1.03 to 2.89; p = 0.039) and secondary prevention patients (HR: 1.91; 95% CI: 1.14 to 3.20; p = 0.014) were at increased risk of ventricular arrhythmias.

Conclusions: Personality modulated the effect of emotional distress; anxiety predicted a 70% increase in risk of arrhythmia in Type D patients but not in other patients. Anxious Type D patients may be identified and offered additional behavioral support after ICD implantation.

Key Words: implantable defibrillator • ventricular arrhythmias • depression • anxiety • Type D personality

Abbreviations and Acronyms
  ACE = angiotensin-converting enzyme
  ATP = antitachycardia pacing
  BDI = Beck Depression Inventory
  CI = confidence interval
  DS14 = Type D scale
  HR = hazard ratio
  ICD = implantable cardioverter-defibrillator
  STAI = State Trait Anxiety Inventory


Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 54: A13-A16. [Full Text] [PDF]



This article has been cited by other articles:


Home page
EuropaceHome page
M. T. Hoogwegt, N. Kupper, D. A. M. J. Theuns, L. Jordaens, and S. S. Pedersen
Beta-blocker therapy is not associated with symptoms of depression and anxiety in patients receiving an implantable cardioverter-defibrillator
Europace, January 1, 2012; 14(1): 74 - 80.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
M. Habibovic, K. C. van den Broek, D. A. M. J. Theuns, L. Jordaens, M. Alings, P. H. van der Voort, and S. S. Pedersen
Gender disparities in anxiety and quality of life in patients with an implantable cardioverter-defibrillator
Europace, December 1, 2011; 13(12): 1723 - 1730.
[Abstract] [Full Text] [PDF]


Home page
Cleveland Clinic Journal of MedicineHome page
J. DENOLLET and V. M. CONRAADS
Type D personality and vulnerability to adverse outcomes in heart disease
Cleveland Clinic Journal of Medicine, August 1, 2011; 78(Suppl_1): S13 - S19.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
J. B. Johansen, P. T. Mortensen, R. Videbaek, S. Riahi, M. Moller, J. Haarbo, and S. S. Pedersen
Attitudes towards implantable cardioverter-defibrillator therapy: a national survey in Danish health-care professionals
Europace, May 1, 2011; 13(5): 663 - 667.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
S. S. Pedersen, K. C. van den Broek, R. A. M. Erdman, L. Jordaens, and D. A. M. J. Theuns
Pre-implantation implantable cardioverter defibrillator concerns and Type D personality increase the risk of mortality in patients with an implantable cardioverter defibrillator
Europace, October 1, 2010; 12(10): 1446 - 1452.
[Abstract] [Full Text] [PDF]


Home page
Circ Cardiovasc Qual OutcomesHome page
J. Denollet, A. A. Schiffer, and V. Spek
A General Propensity to Psychological Distress Affects Cardiovascular Outcomes: Evidence From Research on the Type D (Distressed) Personality Profile
Circ Cardiovasc Qual Outcomes, September 1, 2010; 3(5): 546 - 557.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. M. Roest, E. J. Martens, P. de Jonge, and J. Denollet
Anxiety and Risk of Incident Coronary Heart Disease: A Meta-Analysis
J. Am. Coll. Cardiol., June 29, 2010; 56(1): 38 - 46.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, G. K. Feld, B. H. Greenberg, J. Hall, M. Hlatky, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, et al.
Highlights of the Year in JACC 2009
J. Am. Coll. Cardiol., January 26, 2010; 55(4): 380 - 407.
[Full Text] [PDF]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement