Living with a Defibrillator

Patients with implanted cardiac defibrillators face fear, uncertainty, and many unknowns when deciding to have the device implanted. The implanted cardioverter defibrillator, or ICD, is a small titanium device implanted inside the body that is capable of delivering shock therapy directly to the heart to reverse life threatening arrhythmias. The phenomenon of uncertainty related to ICD patients has been studied internationally at length and in a few domestic quantitive studies, however few recent qualitative studies have been conducted in the USA on this topic. This qualitative study employed face-to-face interviews with five adult participants who talked about their experiences related to living with the device. Because the criteria for ICD implant changes often, many patients have the device implanted and are given little information pre-operatively. Mishel's Theory of Uncertainty was adopted for use in this study. The tool utilized was a battery of four questions developed by the researcher to ask specific details of each participant related to living with the device, their feelings of uncertainty, and lifestyle adaptation. The questions asked included "tell me about the experience of living with your defibrillator"; "tell me about a time when you experienced uncertainty specifically related to the ICD and how you dealt with it"; "tell me about any special considerations that you take while living with the device"; and "describe the timing of your diagnosis related to implant, and how these experiences affected your overal lifestyle". Patients were recruited through a device clinic in one hospital. Three dominant themes were identified including fear, uncertainty, and peace/acceptance of the device implant. Subjective statements were included in the final publication of the study results. Recommendations for further research include a larger participant population, looking at the experiences of men vs. women, and studying the specific idea of what having the ICD means to each patient.