Learning Objective #1: Identify characteristics of implanted cardioverter defibrillator (ICD) recipients during their first three months of treatment

Learning Objective #2: Determine culturally-relevant interventions focused on improving ICD recipient quality of life

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Implanted cardiodefibrillator (ICD) is the standard of care for the treatment of patients with life-threatening or potentially life-threatening ventricular tachyarrhythmias. The first ICD was implanted in 1980. The technology has evolved with smaller devices, more functions, improved batteries and widening therapy indications. There were more than 55,000 implants per year in 2002. In the hospital setting patients are admitted for electrophysiology studies and receive implants with minimal education or psychological preparation. The occurrence of ICD shocks is associated with a significant impairment in quality of life. Patients who receive multiple shocks have higher levels of anxiety, anger and depression. Post implantation care is largely dependent on patient/nurse motivation and health insurance coverage. This presentation will share results of a repeated measures design study, with preoperative, 7-10 days and 3 month follow-up measurement times of ICD recipients in a South Texas urban community. The presentation will report on a research study undertaken to document baseline demographic data, physical assessment, electrophysiological event history, quality of life, anxiety and alcoholic behavior of ICD recipients. Data collection instruments include the SF-36 Health Survey, STAI, CAGE questions and the New York Heart Association (NYHA) Functional Classification System. This study is an early attempt to document the state of the patient as the health care community grapples with the implications of treating potential sudden death. Preliminary findings preoperatively to the 7-day data collection period show no change in the patient-reported quality of life or anxiety level. The New York Heart Association Scale a practitioner rating of the recipient showed a significant difference at the 7-day rating period. It appears the patient does not perceive the improvement in their physical condition. Results from this study will enable nurses in the audience to anticipate developing patient and health care community needs in caring for patients with chronic illnesses.