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Shocktivity: ABILITY AND AVOIDANCE OF DAILY ACTIVITY BEHAVIORS IN ICD PATIENTS

Cutitta, Katherine E. MA; Woodrow, Lawrence K. MA; Ford, Jessica MA; Shea, Julie MS; Fischer, Avi MD; Hazelton, Garrett PhD; Sears, Samuel F. PhD

Journal of Cardiopulmonary Rehabilitation & Prevention: July/August 2014 - Volume 34 - Issue 4 - p 241–247
doi: 10.1097/HCR.0000000000000055
Cardiac Rehabilitation

BACKGROUND: Implantable cardioverter defibrillator (ICD) shocks terminate potentially life-threatening arrhythmias and may alter patient behavior. Patients are aware of which activities they have the ability to perform, but they may choose to avoid these behaviors after receiving a shock. This study examined ICD patient ability and avoidance of progressively exertive behaviors.

METHODS: ICD patients (N = 443) across the United States were surveyed using an online measure including the 12-item Duke Activity Status Index.

RESULTS: As expected, many patients reported being unable to participate in more physically exertive activities such as strenuous athletic exertion (68.8%), sex (35.4%), and running a short distance (49.0%). Avoidance rates were also relatively high, as patients who reported being able to participate in these activities also reported avoiding them (ie, strenuous athletics, 76.1%). Similarly, the majority of patients reported ability to engage in sexual activity (64.6%) but many chose to avoid sexual activity (51.0%). Multiple reasons were reported for avoidance, including fear of shock, fear of heart rate increase, doctor instruction, no desire, and an “other” option.

CONCLUSION: Many ICD patients experience behavioral limitations because of both a perceived inability and preference to avoid exertive activities, and possibly a prescription to do so, particularly strenuous athletic exertion. Clinical and research attention to ICD patient activity levels and reasons for avoidance may improve daily functioning and help patients return to preimplant levels of activity.

Implantable cardioverter defibrillator (ICD) shocks terminate potentially life-threatening arrhythmias and may alter patient behavior. Patients may avoid activities after receiving a shock. Shocktivity examined ICD patient ability and avoidance of progressively exertive behaviors and found ICD patients experience limitations due to perceived inability and preference to avoid exertive activities.

Departments of Psychology (Mss Cutitta and Ford, Mr Woodrow, and Dr Sears), Psychiatric Medicine (Dr Hazelton), and Cardiovascular Sciences (Dr Sears), East Carolina University, Greenville, North Carolina; Brigham and Women's Hospital, Boston, Massachusetts (Ms Shea); and Mount Sinai School of Medicine, New York City, New York (Dr Fischer).

Correspondence: Samuel F. Sears, PhD, Departments of Psychology and Cardiovascular Sciences, East Carolina University, 104 Rawl Bldg, Greenville, NC 27858 (searss@ecu.edu).

Dr Sears serves as a consultant to Medtronic and has or has had research grants from Medtronic and St Jude Medical. All funds are directed to East Carolina University. Dr Sears also has received speaker honorarium from Medtronic, Boston Scientific, St Jude Medical, and Biotronik. Avi Fischer, MD is employed with St Jude Medical. Otherwise, the authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins