Study aims to help heart patients adapt to implanted defibrillators

Professor Jane Irvine, of York University’s psychology department, is helping those heart patients who must use miniature implanted defibrillators to cope with the psychological stress caused by these devices. Implantable Cardioverter Defibrillators (ICDs) are programmed to electrically shock the heart in the event of a life threatening heart rhythm incident.

“The effect of these shocks is similar to the impact of a gunshot to the chest,” explains Irvine. “Many of the patients who have experienced multiple shocks begin to develop symptoms of Post Traumatic Stress Disorder.

“A number of patients also begin to create superstitious associations in their heads in the aftermath of a shock,” adds Irvine. “For example, if someone receives a shock while turning on the radio, they think that if they don’t turn on the radio anymore, they won’t have another heart rhythm problem and thereby be able to avoid ICD shocks.”

Irvine’s team is mid-way through a four-year study, which is being funded by an operating grant from the Heart and Stroke Foundation of Ontario. A manual, based on the thesis of graduate student Jill Stanley, has been created to help implant patients cope with the stress of possible shocks. Additional support is provided through phone counselling. Irvine’s team also promotes education about the implants and teaches meditation and relaxation to help the patients cope with shocks. The goal of Irvine’s study is to create a routine maintenance program for patients who have received these implants. Although the government currently caps the number of defibrillator implants each year, limiting the recipients to patients with known life threatening rhythm problems, there is a move in the United States to use the implants as a preventative strategy as well.

Recent new guidelines have suggested that about 90,000 Canadians should be fitted with the $25,000 defibrillators, although heart specialists acknowledge it's a costly way to save lives. Until now, the devices have been used only in people who have survived a cardiac arrest, about 3,000 per year. Medical experts contend that the devices could save up to one quarter of the deaths in individuals with a weakened heart pump.