Stress Disorder After Cardiac Device Linked to Mortality

Patients with implantable rhythm devices, post-traumatic stress symptoms have higher risk

MONDAY, Nov. 3 (HealthDay News) -- Symptoms of post-traumatic stress disorder (PTSD) have a sizeable influence on mortality in patients with implantable cardioverter-defibrillators, according to research published in the November issue of the Archives of General Psychiatry.

Karl-Heinz Ladwig, Ph.D., M.D., of the Technische Universitaet Muenchen in Munich, Germany, and colleagues analyzed data from 147 patients with the devices, all of whom had had a cardiac arrest or acute myocardial infarction, which qualified them for a criterion of PTSD. Thirty-eight patients scored in the top quartile of the Impact of Event Scale-Revised, and constituted the group with severe PTSD symptoms.

Over a mean 5.1 years of follow-up, the PTSD group had a higher risk of mortality (adjusted hazard ratio, 3.45), the researchers report. These patients also had more anxiety and depression, the authors note.

"The findings underline the urgent need for routinely applied comprehensive and interdisciplinary psychosocial aftercare for patients with implantable cardioverter-defibrillators. In particular, the present data suggest that PTSD is an important source of psychological distress in patients with implantable cardioverter-defibrillators having symptoms persisting for many years that should not be overlooked. Although the serious mortality risk of PTSD in patients with implantable cardioverter-defibrillators needs to be further investigated before firm recommendations can be made, screening for PTSD symptoms in patients with implantable cardioverter-defibrillators is likely to be clinically beneficial, and treatment in selected patients should be attempted," the authors conclude.

Two of the study co-authors disclosed financial relationships with Medtronic.

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