Abstract 16559: Implantable Cardioverter Defibrillator Recipient’s Perceptions of Healthcare Provider’s Discussions Related to Device Therapy
Introduction: Healthcare providers are challenged to have in-depth discussions related to deactivation and illness trajectory with ICD recipients. However, these discussions may be perceived differently after the ICD recipient has had a shock event from the device.
Purpose: To examine the association between ICD shock experience and discussion about deactivation and illness trajectory.
Methods: A total of 190 ICD recipients (74% male, mean age 61.5 years of age ± 13.5; range 20-89 years old) from US (n=144) and Australia (n= 46) completed a cross sectional survey. Inclusion criteria required ICD device implantation for greater than one year. Odds ratio was used to examine the association between those patients who received ICD shocks or not and the discussion perceptions with healthcare providers about deactivation and illness trajectory. Chi square was used to compare the differences between the samples from the US and Australia and to calculate risk ratios.
Results: Fifty eight percent of participants were diagnosed with HF and 32.5% had received shocks. There were significant associations of having discussions with healthcare providers about deactivation (X2(1) =14.35, p<.001) and illness trajectory (X2 (1)=5.56, p=.018) with ICD shock experience. The ICD recipients who experienced ICD shocks were 3.5 times more likely to discuss deactivation with healthcare providers and 2.2 times more likely to discuss their illness trajectory than those who did not experience ICD shocks. ICD recipients who had ICD shocks were more likely to discuss deactivation (OR 2.29, p<.027) and illness trajectory (OR 1.96, p<.039) with family members than those who did not receive ICD shocks. ICD recipients who experienced an ICD shock were 3.0 times more likely to consider having a discussion with healthcare providers about deactivation than those who did not (p=.014).
Conclusions: International evidence-based guidelines exist to direct healthcare providers that preimplantation is the ideal time to have important discussions with ICD recipients related to ICD deactivation and progression of disease status. Our data suggest that ICD recipients are more likely to perceive these discussions as pertinent once they have received shock treatments from their device.
Author Disclosures: M.J. Biddle: None. J. Kang: None. J.L. MIller: None. M. Hammash: None. J. Cameron: None. M.L. Chung: None. D.K. Moser: None.
- © 2016 by American Heart Association, Inc.