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Pacemakers and Implanted Defibrillators Have Negative Impact on Quality of Life of Children and Teens

Wednesday, December 05, 2012

Pacemakers and implanted defibrillators are often necessary as part of long-term cardiac care or to prevent sudden death in many children and teens with heart disease. A new study, however, shows that these cardiac rhythm devices may have a significant, negative impact on their quality of life.

The multi-center study, led by physicians at Cincinnati Children’s Hospital Medical Center, shows that quality of life is particularly affected for those with congenital heart disease and implanted defibrillators, which control irregular heartbeats and prevent sudden cardiac arrest.

The study is published online in the journal Circulation: Arrhythmia and Electrophysiology.

“Patients and their parents reported significantly lower quality of life scores,” says Richard Czosek, MD, a pediatric cardiologist at the Cincinnati Children’s Heart Institute. “Interestingly, the drivers of quality of life differed between patients and their parents. For patients, self-perception was the key driver of lower quality of life, while for parents behavioral issues were associated with lower quality of life. This held true even for patients with milder forms of congenital heart disease.”

Cardiac rhythm devices are used to treat abnormal heart rhythms. One kind of device, pacemakers, monitor and correct slow heart rhythms. Another kind, implanted cardiac defibrillators (ICDs), also continuously monitor heart rhythms but are used to treat fast and potentially life-threatening heart beats. Each has become increasingly used in children and teens.

Despite technological and implantation improvements, these devices are not without associated complications and disease prevalence. In Dr. Czosek’s study, for example, nearly half of the shocks that patients received from the devices were “inappropriate.”

“These findings should encourage us to consider the negative impact of devices, particularly defibrillators, on pediatric patients and to develop strategies to mitigate these effects,” says Dr. Czosek. “Whether these effects on quality of life can be reduced through the use of psychotherapy or other means needs to be assessed.”

The researchers studied 173 children and teens between the ages of 8 and 18, and their parents. Forty patients had ICDs and 133 had pacemakers. The study compared these children not only to those without heart problems but also to those with milder forms of congenital heart disease.