Fear of shock from heart implants may lead to sexual dysfunction

AHA Scientific Sessions 2011

New data presented at the American Heart Association Scientific Sessions 2011 demonstrate that patients with implantable cardioverter defibrillators have high levels of shock-related anxiety that may interfere with sexual function.

Sexual function and ICDs

Stephen C. Cook, MD, director of the Adult Congenital Heart Disease Center at Children’s Hospital of Pittsburgh, and colleagues conducted a prospective, multicenter, cross-sectional study of adult congenital heart disease patients with and without ICDs to identify issues surrounding ICD-related shock anxiety and sexual function. Men were asked to rate their sexual function, level of depression, and levels of fear and anxiety about experiencing an ICD shock. Women were questioned on their interest, arousal, satisfaction and pain during sex.

In the group of patients with ICDs (n=41; 41% women), Sexual Health Inventory for Men scores were lower vs. the group of patients without ICDs (n=110; 49% women). No differences were found in Female Sexual Function Index or Beck Depression Inventory-II scores between the two groups. A higher level of shock-related anxiety was indicated by greater Female Sexual Function Index scores vs. normative scores (18.2 vs. 15.44; P=.03), greater consequence scores vs. normative scores (6.3 vs. 1.54; P<.001) and greater trigger scores vs. normative scores (4.6 vs. 1.55; P<.001).

“Communication among health care providers and patients is essential,” Cook said in a press release. “Patients require counseling both before and after device placement, particularly if they continue to report high levels of nervous feelings.”

Mental, physical health of significant others

In a separate study presented at the meeting, Cynthia M. Dougherty, PhD, ARNP, of the University of Washington School of Nursing, and colleagues examined the mental and physical health of the significant others of patients with ICDs. Physical and mental health were measured in the significant others using Short Form-12 physical and mental component summaries, the Center for Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory for Adults. Data were collected at 1, 3, 6 and 12 months.

Researchers enrolled 127 significant others (mean age, 60.9 years; 84% women) in the study. Results showed that participants' physical health declined from baseline to 1 year, with the biggest change occurring between hospital discharge and 3 months after their spouses underwent ICD implantation, suggesting that the post-hospital period was the most difficult.

"The psychological demands and adjustment were most challenging for the caregivers immediately after the patients left the hospital," the researchers said in a press release. "Early symptoms included high anxiety, depression and increased physical symptoms."

Nevertheless, data revealed that the mental health of significant others improved between baseline and 1 year while caregiving demands were also reduced during this period. Therefore, the researchers recommended developing interventions to help caregivers adjust during the first 3 months after implantation.

For more information:

Cook SC. Abstract #14165.
Dougherty CM. Abstract #10800. Both presented at: American Heart Association Scientific Sessions 2011; Nov. 12-16, 2011; Orlando, Fla.

Disclosure: Drs. Cook and Dougherty report no relevant financial disclosures.

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