Implantable cardioverter defibrillator implant‐explant‐implant case study: Addressing the psychological adjustment to multiple shocks

This case study details the multidisciplinary approach to a patient who underwent implantable cardioverter defibrillator (ICD) explantation for psychological reasons. The patient was unable to manage the stress associated with multiple shocks. He had a class I indicationfor an ICD but initially refused to undergo reimplantation. Treatment included the provision of comprehensive medical, nursing, and psychological care, with emphasis on patient autonomy and respect forthe patient's experience.

[1]  K. Gauvreau,et al.  Psychosocial factors and quality of life in children and adolescents with implantable cardioverter-defibrillators. , 2004, The American journal of cardiology.

[2]  D. Hayes,et al.  Ethical analysis of withdrawal of pacemaker or implantable cardioverter-defibrillator support at the end of life. , 2003, Mayo Clinic proceedings.

[3]  Brian Baker,et al.  Quality of life in the Canadian Implantable Defibrillator Study (CIDS). , 2002, American heart journal.

[4]  J. Oss,et al.  PROPHYLACTIC IMPLANTATION OF A DEFIBRILLATOR IN PATIENTS WITH MYOCARDIAL INFARCTION AND REDUCED EJECTION FRACTION , 2002 .

[5]  J. Conti,et al.  Young at Heart: Understanding the Unique Psychosocial Adjustment of Young Implantable Cardioverter Defibrillator Recipients , 2001, Pacing and clinical electrophysiology : PACE.

[6]  K. Lee,et al.  A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. , 1999, The New England journal of medicine.

[7]  A. Camm,et al.  Examining the psychosocial impact of implantable cardioverter defibrillators: A literature review , 1999, Clinical cardiology.

[8]  M. Keller,et al.  A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. , 1997, The New England journal of medicine.

[9]  A. Moss,et al.  Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. , 1996, The New England journal of medicine.

[10]  S. Barold,et al.  Discontinuing an implantable cardioverter defibrillator as a life-sustaining treatment. , 1994, The American journal of cardiology.

[11]  S. Furman,et al.  Clinical Outcome Following ICD Removal , 1993 .

[12]  N Engl,et al.  Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. , 1997, Circulation.

[13]  Epstein The Multicenter Automatic Defibrillator Implantation Trial. , 1997, Journal of cardiovascular pharmacology and therapeutics.