VIENNA — Psychiatric assessment of 82 Turkish patients who had received implantable cardioverter defibrillators showed that the recipients had a high prevalence of sexual dysfunction, posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder, Dr. Irem Yalug said while presenting two posters at the annual congress of the European Society of Cardiology.
Psychiatric assessment and counseling should be part of routine follow-up after implantable cardioverter defibrillator (ICD) placement, said Dr. Yalug, a psychiatrist at Kocaeli (Turkey) University. As part of this work-up, patients should be assessed and informed that sexual activity will not boost their risk of an ICD shock, she added.
Dr. Yalug and associates studied patients at risk for lethal ventricular arrhythmias who received ICDs for either the primary or secondary prevention of a sudden cardiac event at Kocaeli University during 2002–2006. The group included 69 men and 13 women, with an average age of 59 years. All patients had their ICDs for at least 3 months.
Patients were assessed using sociodemographic and psychiatric questionnaires, including the Structured Clinical Interview for DSM-IV and Arizona Sexual Experience Scale.
The results showed a high prevalence of psychiatric disorders, including PTSD and major depressive disorder. (See box.) The average score on the Arizona Sexual Experience Scale was about 17, a “very high score” indicating abnormalities on a scale where 11 is at the upper level of normal, Dr. Yalug said.
The traumatic event that triggered PTSD was either a ventricular arrhythmia or the placement of the ICD. Patients also showed a high prevalence of multiple disorders. About 60% of the patients with depression also had PTSD; about 40% of those with PTSD also had depression.
“We saw a high rate of concern about sexual activity in these patients,” Dr. Yalug said. “To improve quality of life and reduce anxiety, patients should be assessed and counseled about sexual activity as soon as possible after ICD placement.” Avoiding sexual activity may lead to some of the other sequelae seen in this study, such as depression, she said.
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