AICD and iatrogenic psychopathology

Research output: Contribution to journalArticlepeer-review

Abstract

The automatic implantable cardioverter-defibrillator (AICD) is currently standard treatment for managing recurrent life-threatening malignant ventricular tachyarrhythmias. While AICDs have improved mortality rates from sudden cardiac death in high-risk patients, implantation of the device has significant psychological and emotional impact. Living with an AICD can be stressful. An acute ventricular arrhythmia triggers an AICD firing that is felt as a shock or a spasm causing the entire body to jump. This discharge is so noxious that after experiencing it, many patients describe fearing not only the arrhythmia but also the firing of the device. The psychological and emotional sequelae of AICD placement vary, hut patterns of reaction that have been described include anxiety, fear, panic attacks, depression, mood lability, and anger. We report 3 cases of AICD-induced anxiety disorder in patients without preexisting psychiatric illness and suggest the possibility that the very treatment which saves lives can induce potentially disabling psychopathology. Data from clinical samples of limited size and anecdotal reports describe post-AICD implantation psychopathology. The literature is essentially silent on whether subjects had pre-AICD psychopathology. Recognizing that these lifesaving devices can cause new-onset anxiety and depressive disorders may lead to better management strategies in these patients.

Original languageEnglish (US)
Pages (from-to)162-163
Number of pages2
JournalPrimary Care Companion to the Journal of Clinical Psychiatry
Volume4
Issue number4
StatePublished - Dec 1 2002

ASJC Scopus subject areas

  • Psychiatry and Mental health

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