05 December 2012

Children With Heart Devices May Benefit From Psychotherapy In Coping With Lower Quality of Life

Children with heart conditions and carry an implantable cardiac device (ICD) may benefit from psychotherapy to deal with a lower quality of life based on their self perception, self worth, and athletic ability.

Implantable Cardiac Devices (ICD) are used to treat heart conditions such as arrhythmia (irregular heartbeat). Pacemakers and implanted defibrillators to ensure that the heart is beating normally at all times.

Having an ICD and coping with the change in lifestyle it brings is an ongoing process. It affects the person both physically and psychologically.

Most patients with ICD have frequent anxiety whether the device is working or not. And even in the event that the device such as the implanted defibrillator does work, it doubles the patient's stress levels.

Most devices are also replaced after several years of use which requires minor surgery.

For children, the burden of living with an ICD is hard. Being naturally active, having an ICD affects the way they behave and act which results in a lower quality of life. Parents feel the same as their child’s behavior was the biggest factor related to quality of life.

Psychotherapy Help Parents and Children Cope

Children with implanted heart-rhythm devices and their parents suffer from a lower quality of life compared with their healthy counterparts and may benefit from psychotherapy according to new research in Circulation: Arrhythmia & Electrophysiology, an American Heart Association journal.

Researchers at the Cincinnati Children's Hospital Medical Center studied 173 children with either a pacemaker (40 patients) or implanted defibrillator (133 patients) to assess their quality of life compared to other children with congenital heart disease and to healthy children. The children, ages 8 to 18 years old, and their parents completed quality of life questionnaires.

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Compared with healthy children and their parents, children with heart devices and their parents reported significantly lower quality of life scores. Likewise, their scores were also lower than those of children with mild congenital heart disease. However, their quality of life scores were similar to those for children with more severe heart disease but no device.

For children, self-perception, self-worth, and athletic capability affected quality of life.

For parents, their child's behavior was the biggest factor related to quality of life.

Also, children with an implantable defibrillator tended to have lower quality of life scores than those with pacemakers.

"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," said Richard J. Czosek, M.D., study author and assistant professor of pediatrics at the Cincinnati Children's Hospital Medical Center, Heart Institute in Ohio. "Whether these effects on quality of life can be reduced through the use of psychotherapy needs to be assessed."


American Heart Association
Circulation: Arrhythmia & Electrophysiology
Heart Institute - Cincinnati Children's Hospital Medical Center
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