Sex differences in the course of implantable cardioverter defibrillator concerns (Results from the Danish national DEFIB-WOMEN study)

OBJECTIVE: The implantable cardioverter defibrillator (ICD) is used to treat malignant ventricular arrhythmias. Since 33% of patients experience ICD-related concerns, we examined sex differences in ICD concerns and correlates of ICD concerns during 24 months of follow-up after implantation of an ICD.

METHODS: Patients from the DEFIB-WOMEN study (n = 1515; 81.6% male patients) completed questionnaires on ICD concerns, anxiety, depression, and Type D personality at five measure points (baseline, 3-, 6-, 12- and 24-months post-implantation).

RESULTS: Male patients scored on average 7.0 (6.8) points on ICD concerns at the time of implantation and female patients scored on average 10.5 (8.2) points. We found statistically significant sex differences in ICD concerns at all measurement points, with female patients scoring 2.77 points (8.7% of the maximum score of 32) higher than male patients. ICD concerns decreased in both sexes the first 6 months and then levelled out. For both sexes, ICD concerns at baseline were significantly correlated with ICD concerns at 24-months follow-up. Anxiety at baseline was correlated with ICD concerns in female patients, while depression at baseline and at least one experienced shock correlated with ICD concerns in male patients.

CONCLUSION: Female patients reported more ICD concerns at all measurement points compared to male patients, but for both sexes ICD concerns decreased in the first 6 months. ICD shock, anxiety, depression, and ICD concerns at baseline were correlates of ICD concerns at 24-months follow-up.