Phantom Shocks in Implantable Cardioverter-defibrillator Recipients: Impact of Education Level, Anxiety, and Depression

Overview

Journal Herzschrittmacherther Elektrophysiol

Date 2019 Aug 24

PMID 31440897

Citations 4

Authors

Swaroop Varghese

J Christoph Geller

Marc-Alexander Ohlow

Affiliations

Soon will be listed here.

Abstract

Background: Implantable cardioverter defibrillators (ICDs) are designed to deliver shocks in the event of ventricular arrhythmias. Some ICD recipients experience the sensation of ICD discharge in the absence of an actual discharge (phantom shock, PS).

Objectives: The aim of this study was to evaluate the incidence, predictors, and consequences of PS in ICD recipients.

Materials And Methods: Consecutive ICD recipients were examined during a routine outpatient follow-up (FU) visit. Subjects completed a written survey; their level of depression and anxiety was assessed with the hospital anxiety and depression scale (HADS). Quality of life (QOL) was assessed using the Minnesota living with heart failure questionnaire.

Results: Of 434 patients invited to the study, 423 (97.5%) ICD recipients agreed to and completed the survey; 349 (83%) had a primary prevention indication and 339 (80%) ischemic cardiomyopathy. A total of 27 patients (6.4%) reported a PS during a mean FU of 64 ± 44 months (5.4% in the primary prevention group and 10.8% in the secondary prevention group; p = 0.11). PS were related to higher education (≥bachelor's degree 41% versus 20%; p = 0.03), and more frequent in patients receiving adequate shocks during FU (34% versus 0.5%; p < 0.001). HADS score levels were higher following PS (15 ± 6 versus 8.8 ± 7.4; p < 0.001). The majority of patients reporting PS felt that the information provided to them prior to ICD placement was insufficient (22.2% versus 5.0%), that they needed psychological support after ICD implantation (26% versus 3%), and considered ICD deactivation in near end-of-life situations (59% versus 29%; p < 0.001 for all).

Conclusions: PS occur in 6.4% of all ICD recipients and are related to higher education and to patients that experienced adequate shocks during FU.

Citing Articles

Crea P, Cocuzza F, Bonanno S, Ferrara N, Teresi L, La Maestra D J Clin Med. 2025; 14(4).

PMID: 40004852 PMC: 11856071. DOI: 10.3390/jcm14041322.

Incidence, Risk Factors and Predictors of Phantom Shocks in Patients with Implantable Cardioverter Defibrillators: State-of-the-art Review.

Elenizi K, Alharthi R Arrhythm Electrophysiol Rev. 2024; 13:e18.

PMID: 39569079 PMC: 11577870. DOI: 10.15420/aer.2024.25.

Understanding Phantom Shocks in Implantable Cardioverter-Defibrillator Recipients.

Galo J, Feroze R, Almas T, Morera J, Sahadevan J Cureus. 2024; 16(1):e53161.

PMID: 38420102 PMC: 10900171. DOI: 10.7759/cureus.53161.

Phantom Shocks Associated With a Wearable Cardioverter Defibrillator.

Delle Donna P, Petrovic L, Nasir U, Ahmed A, Suero-Abreu G J Med Cases. 2021; 12(2):49-53.

PMID: 34434428 PMC: 8383611. DOI: 10.14740/jmc3606.

Decision regret in implantable cardioverter-defibrillator recipients : A cross-sectional analysis on patients that regret their decision after ICD implantation.

Varghese S, Geller J, Ohlow M Herzschrittmacherther Elektrophysiol. 2020; 31(1):77-83.

PMID: 32078717 DOI: 10.1007/s00399-020-00675-x.

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