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Tilburg University Towards a Comprehensive Understanding Of Tilburg University Towards a comprehensive understanding of patients with an implantable cardioverter- defibrillator Hoogwegt, M.T. Publication date: 2014 Document Version Publisher's PDF, also known as Version of record Link to publication in Tilburg University Research Portal Citation for published version (APA): Hoogwegt, M. T. (2014). Towards a comprehensive understanding of patients with an implantable cardioverter- defibrillator: A biopsychosocial approach. Ridderprint. 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Download date: 27. sep. 2021 Towards a comprehensive understanding of patients with an implantable cardioverter-defibrillator with an implantable understanding of patients a comprehensive Towards UITNODIGING Towards a comprehensive voor het bijwonen van de openbare verdediging understanding of patients van mijn proefschrift with an implantable Towards a comprehensive understanding of patients cardioverter-defibrillator with an implantable cardioverter-defibrillator A biopsychosocial approach A biopsychosocial approach Op vrijdag 12 september 2014 om 14.00 uur in de aula van Tilburg University Warandelaan 2 te Tilburg Na afloop van de plechtigheid bent u van harte welkom op de receptie in Grand Café Esplanade ter plaatse Paranimfen Dionne Kessing Maria Sleddering Marjan Traa [email protected] Madelein Hoogwegt Madelein Hoogwegt Regentesselaan 157a 2562 CW ’s Gravenhage Madelein Hoogwegt [email protected] Hoogwegt_Omslag.indd 1 16-07-14 09:06 TOWARDS A COMPREHENSIVE UNDERSTANDING OF PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR A BIOPSYCHOSOCIAL APPROACH Madelein T. Hoogwegt TOWARDS A COMPREHENSIVE UNDERSTANDING OF PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR A BIOPSYCHOSOCIAL APPROACH ISBN: 978-90-5335-897-9 Cover design Nikki Vermeulen, Drukkerij Ridderprint, Ridderkerk Lay-out Nikki Vermeulen, Drukkerij Ridderprint, Ridderkerk Printing Drukkerij Ridderprint, Ridderkerk © Madelein T. Hoogwegt, ‘s Gravenhage, the Netherlands. All rights reserved. No parts of this thesis may be reproduced or transmitted in any form, by any means, without prior written permission of the author. The copyright of the articles that have been published or have been accepted for publication has been transferred to the respective journals. TOWARDS A COMPREHENSIVE UNDERSTANDING OF PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR A BIOPSYCHOSOCIAL APPROACH Proefschrift ter verkrijging van de graad van doctor aan Tilburg University op gezag van de rector magnificus, prof. dr. Ph. Eijlander, in het openbaar te verdedigen ten overstaan van een door het college voor promoties aangewezen commissie in de aula van de Universiteit op vrijdag 12 september 2014 om 14.15 uur door Magdalena Theresia Hoogwegt geboren op 17 juli 1985 te Venlo PROMOTIECOMMISSIE Promotor Prof. dr. S.S. Pedersen Copromotores Dr. H.M. Kupper Dr. D.A.M.J. Theuns Overige leden Dr. K.C. van den Broek Prof. dr. J.K.L. Denollet Prof. dr. J.C.N. de Geus Dr. E.G.Th.M. Hartong Dr. S.E. Hoeks Prof. dr. J.L.R.M. Smeets Financial support by the Dutch Heart Foundation for the publication of this thesis is gratefully acknowledged. PARANIMFEN Dionne Kessing Maria Sleddering Marjan Traa CONTENTS Chapter 1 General introduction and outline of the dissertation 9 Part one Medical treatment, clinical characteristics and their association with emotional distress Chapter 2 Procedure- and device-related complications and psychological 29 morbidity in implantable cardioverter-defibrillator patients Chapter 3 Comorbidity burden is associated with poor psychological well- 37 being and physical health status in patients with an implantable cardioverter-defibrillator Chapter 4 Beta-blocker therapy is not associated with symptoms of 51 depression and anxiety in patients receiving an implantable cardioverter-defibrillator Chapter 5 Relation of statin therapy to psychological functioning in patients 65 with an implantable cardioverter-defibrillator Part two In search of a psychophysiological link between emotional distress and clinical outcomes: Autonomic nervous system function as a candidate mechanism Chapter 6 Relation between emotional distress and heart rate variability in 79 patients with an implantable cardioverter-defibrillator Chapter 7 Long-term mortality risk in patients with an implantable 97 cardioverter-defibrillator: Influence of heart rate and QRS duration Part three Looking beyond the scope of the patient: The impact of partners of ICD patients Chapter 8 Interrelationship between emotional distress of implantable 113 cardioverter-defibrillator patients and their partners: Influence on patients’ health status the first 12 months post implantation Chapter 9 Long-term mortality risk in patients with an implantable 135 cardioverter-defibrillator: Influence of emotional distress of their partners Part four Inside the consulting room – helping the patient to get back on track Chapter 10 Information provision, satisfaction and emotional distress in 151 patients with an implantable cardioverter-defibrillator Chapter 11 Undertreatment of anxiety and depression in patients with an 165 implantable cardioverter-defibrillator: Impact on health status Chapter 12 General discussion and summary of the results 181 Addendum Mediation model depression, heart rate and mortality 201 Summary in Dutch / Nederlandse samenvatting 205 Acknowledgements / Dankwoord 213 List of publications 219 About the author 223 General introduction and outline of the dissertation 1 General introduction | 11 Sudden cardiac death Sudden cardiac death (SCD) refers to an unexpected natural death due to a cardiac cause that is usually attributed to a very fast heart rhythm caused by an electrical disturbance of the heart.1 Ventricular tachycardia (VT) refers to an accelerated rhythm of >100 beats per minute in the heart’s ventricles. VT often results in a reduced pump function of the heart, which causes symptoms such as dizziness, lightheadedness, and heart beat sensations that feel like pounding.2 VT can deteriorate into ventricular fibrillation (VF), with quick, chaotic electrical impulses causing the ventricles to contract in an asynchronous manner. This leads to insufficient blood flow to vital organs and to sudden cardiac arrest, and eventually to SCD if left untreated (Figure 1). SCD may occur in individuals with or without preexisting cardiovascular disease, although many have a previous cardiac history, and may have experienced an acute myocardial infarction (MI), a cardiac arrest or suffer from severe heart failure.2 Figure 1. Pathophysiology and epidemiology of sudden death from cardiac causes Reproduced with permission from Huikuri HV, Castellanos A & Myerburg RJ. Sudden death due to cardiac arrhythmias. New England Journal of Medicine 2001;345(20):1473-1482. © Massachusetts Medical Society. 12 | Chapter 1 The incidence of SCD varies between countries and depends on the defi nition used, but recent prospective studies have shown worldwide annual incidences ranging from 50-100 per 100.000 in the general population.3-5 Due to improved primary and secondary prevention, the mortality risk due to coronary heart disease (CHD) has declined considerably during the past decades,6,7 while mortality rates due to SCD remain high.8,9 Still more than 50% of all CHD deaths are caused by SCD, and SCD accounts for 15-20% of all deaths, which emphasizes the importance of adequate measures to prevent SCD.1 The implantable cardioverter-defi brillator – a continuously evolving fi eld In the late 1960s, the development of the implantable cardioverter-defi brillator (ICD) was pioneered by Michel Mirowski, as he was frustrated by lack of available treatment options for a close friend who had been admitted to hospital with recurrent VTs. He envisaged the implantation of a continuous guard of the cardiac rhythm that could deliver defi brillation in the event of VT/VF. After building and refi ning experimental models during the 1970s, the fi rst human cardiac electronic device was implanted in 1980 in a patient who had suff ered two previous cardiac arrests.10,11 While the ICD at fi rst was limited to patients with documented cardiac arrest due to VF and was only implanted in a small number of centers, the United States Food and Drug Administration (FDA) approved the use of commercial devices in 1985.10 This was the start of a revolutionary treatment for the prevention of SCD that has continued to evolve. Figure 2. The transvenous implantable cardioverter-defi brillator12 The ICD is an electronic device that is implanted right under the skin in the pectoral area, where it continuously monitors the heart rhythm (Figure 2). Detection of VTs is based on information derived from the high-voltage defi brillation lead placed in the right ventricle. Therapies for VTs
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