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  1. Samuel F Sears Jr,
  2. Jamie B Conti
  1. Correspondence to:
    Samuel F Sears Jr, PhD, University of Florida, Department of Clinical & Health Psychology, Box 100165 UF Health Science Center, Gainesville, FL 32610, USA;

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The use of the implantable cardioverter-defibrillator (ICD) for life threatening ventricular arrhythmias is standard therapy, in large part because clinical trials data have consistently demonstrated its superiority over medical treatment in preventing sudden cardiac death.1 This success prompts closer examination and refinement of quality of life (QOL) outcomes in ICD patients. Although no universal definition of QOL exists, most researchers agree that “quality of life” is a generic term for a multi-dimensional health outcome in which biological, psychological, and social functioning are interdependent.2 To date, the clinical trials demonstrating the efficacy of the ICD have focused primarily on mortality differences between the ICD and medical treatment. While the majority of the QOL data from these trials is yet to be published, many small studies are available for review and support the concept that ICD implantation results in desirable QOL for most ICD recipients.3 In some patients, however, these benefits may be attenuated by symptoms of anxiety and depression when a shock is necessary to accomplish cardioversion or defibrillation. This paper reviews the published literature on QOL and psychological functioning of ICD patients and outlines the clinical and research implications of these findings.


Definitive conclusions about QOL differences between patients managed with an ICD and those treated with antiarrhythmic drugs are difficult to make in the absence of large, randomised, controlled trials. Available evidence indicates that ICD recipients experience a brief decline in QOL from baseline but improve to pre-implant levels after one year of follow up.4 The largest clinical trial data published in final form is from the coronary artery bypass graft (CABG) Patch trial which randomised patients to ICD (n = 262) versus no ICD (n = 228) while undergoing CABG surgery.5 In contrast to May and colleagues,4 data from this trial indicate …

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