Device Adjustment and Recovery in Patients With Heart Failure Undergoing a Cardiac Resynchronization Therapy Implantation A Longitudinal Study
2022 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 37, no 3, p. 221-230Article in journal (Refereed) Published
Abstract [en]
Background Little is known about risk factors for poor adjustment to the device after cardiac resynchronization therapy (CRT) implantation in patients with heart failure. Purpose The aim of this study was to explore device adjustment and the postoperative recovery of patients with heart failure undergoing elective CRT device implantation. Methods In this prospective multicenter longitudinal study, data were collected before implantation and after 2 weeks, 6 months, and 1 year, using validated self-reported instruments and investigator-designed, CRT-specific questions. Results A total of 133 patients, 79% male, with a mean age of 70 +/- 10 years, were included. Patients adjusted to the device over time (P < .001), but 20% of patients had difficulties after 2 weeks, and 11% had difficulties at the 1-year follow-up. Fatigue was the most common health problem before surgery (87%), which was reduced to 65% after 1 year, P < .001. Patients recovery improved over time (P < .001). Device-specific problems with hiccups (7% vs 14%), pulsation around the device (29% vs 24%), tachycardia (28% vs 29%), appearance of the scar (21% vs 17%), and the device bulging out (65% vs 61%) remained unchanged over time, whereas stiffness in the shoulder (64% vs 28%, P < .001) and wound healing (9% vs 2%, P < .05) improved. Conclusions Most patients with heart failure recover and adjust early after their CRT implantation and improve even more during follow-up. However, recovery and adjustment are problematic for some patients, and many experience bodily discomforts because of the device. Early screening for poor adjustment and psychological distress can lead to appropriate interventions and timely referrals. This is important in the era of remote monitoring with less face-to-face contact.
Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2022. Vol. 37, no 3, p. 221-230
Keywords [en]
adjustment disorders; cardiac resynchronization therapy devices; defibrillators; heart failure; implantable; minor surgical procedures
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-184720DOI: 10.1097/JCN.0000000000000795ISI: 000781173700012PubMedID: 33657066OAI: oai:DiVA.org:liu-184720DiVA, id: diva2:1656335
Note
Funding Agencies|Landspitali University Hospital Research Fund, Landspitali - The National University Hospital of Iceland; Icelandic Nurses Association Research Fund; Research Fund of Ingibjorg Magnusdottir in Iceland; Heart Failure Association of the ESC HF Nurse Training Fellowship
2022-05-052022-05-052022-05-05