Guidelines Issued for Improving Outcomes for ICD Recipients

AHA scientific statement addresses educational, psychological outcomes for patients and families

TUESDAY, Sept. 25 (HealthDay News) -- Patient and family education and psychological support are key components for improving outcomes for implantable cardioverter defibrillator (ICD) recipients, according to a scientific statement issued by the American Heart Association and published online Sept. 24 in Circulation.

Based on analysis and critique of the existing research, Sandra B. Dunbar, R.N., D.S.N., chair of the AHA's Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young, and colleagues developed recommendations for improving patient care for ICD recipients and pinpointed areas requiring further investigation. The statement has been endorsed by the Heart Rhythm Society and the American Association of Critical-Care Nurses.

The scientific statement addresses the psychological well-being and quality of life of ICD recipients; describes the concerns and educational needs of patients and their families; outlines the evidence supporting interventions for improved educational and psychological outcomes; and provides recommendations for clinical approaches to improve patient care, including explaining the role of the ICD to the patient, developing a patient and family "plan of action" in the event of a shock, and providing age-and sex-specific information.

"Providers need to help patients address ICD-specific concerns about symptoms, heart disease treatment, physical activities, and end-of-life issues," Dunbar said in a statement. "Experiencing a shock is distressing and patients have a wide variety of responses. Some find it very reassuring that it's working, while others find the actual physical sensations frightening and overwhelming. That's why we suggest that clinicians provide an ongoing assessment of ICD patients' psychological needs."

Several authors disclosed financial ties to the medical device and/or pharmaceutical industries.

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