Heart Devices Affect Life Quality for Kids

Pediatric patients with implanted heart devices have lower quality of life

(RxWiki News) Adults with implanted heart rhythm devices commonly experience lower quality of life. But when it comes to children, little is known about how it impacts life quality.

Researchers have found that both kids with implanted heart devices, as well as their parents, report significantly lower quality of life scores.

"Discuss appropriate arrhythmia treatment options with a cardiologist."

Richard J. Czosek, MD, study author and assistant professor of pediatrics at the Cincinnati Children’s Hospital Medical Center, Heart Institute in Ohio, said the discovery that both implanted cardioverter defibrillators (ICDs) and pacemakers negatively impact pediatric patients and their parents allows clinicians to develop strategies to lessen the impact.

He said an assessment will be necessary to determine whether psychotherapy could negate some of the effects.

A pacemaker is a small device implanted in the chest to control an abnormal heart rhythm through electrical pulses. An ICD, also implanted in the chest, sends electrical pulses or shocks in patients at risk of sudden cardiac death.

During the multi-center study, investigators followed 173 children between the ages of 8 and 18. Of those pediatric patients, 40 had a pacemaker and 133 had an ICD. Many of the patients -- 60 percent in the pacemaker group -- also had congenital heart disease.

Both kids and their parents filled out questionnaires to assess quality of life. Researchers compared the findings to healthy parent/child pairs as well as children with congenital heart disease and their parents.

As compared to healthy children and their parents, pediatric heart device patients and their parents reported significantly lower quality of life. Children with heart devices and their parents also reported lower quality of life compared to those with mild congenital heart disease.

Quality of life scores among kids and parents were similar between the group with heart devices and those with more severe heart disease.

Parents indicated the lower quality of life stemmed from behavioral issues, while children said self-perception, self-worth and athletic abilities influenced their quality of life.

Investigators also found that kids with ICDs tended to report a lower quality of life as compared to those with pacemakers. Though the study did not examine the reason, adults with ICDs often experience anxiety about the prospect of receiving a shock from the device.

A large percentage of the children with ICDs had previously received a shock from their device, of which about half of those were considered appropriate. However, researchers found pediatric patients who had previously received shocks did not report lower quality of life.

One of the investigators was paid an honorarium to speak at a St. Jude fellow conference and also received an institutional fellow training grant funded by St. Jude and Medtronic, which manufactures heart devices.

The study was recently published in Circulation: Arrhythmia & Electrophysiology, an American Heart Association journal.

Review Date: 
December 4, 2012