Faculty Collaboration Database

Impact of cardiac devices on the quality of life in pediatric patients. Circ Arrhythm Electrophysiol 2012 Dec;5(6):1064-72

Date

12/06/2012

Pubmed ID

23212181

DOI

10.1161/CIRCEP.112.973032

Scopus ID

2-s2.0-84873803149 (requires institutional sign-in at Scopus site)   69 Citations

Abstract

BACKGROUND: Cardiac rhythm devices are increasingly used in the pediatric population, although their impact on quality of life (QOL) is poorly understood. The purpose of this study was to compare (QOL) scores among pediatric device patients, healthy controls, and congenital heart disease (CHD) patients and determine the key drivers of QOL in pediatric device patients.

METHODS AND RESULTS: Multicenter, cross-sectional study at 8 pediatric centers of subjects aged 8 to 18 years with either a pacemaker or defibrillator was carried out. Patient-parent pairs completed the Pediatric Quality of Life Inventory and Pediatric Cardiac Quality of Life Inventory. QOL outcomes in device patients were compared with healthy controls and patients with various forms of CHD. Structural equation modeling was used to test for differences in Pediatric Cardiac Quality of Life Inventory scores among (1) device type, (2) presence of CHD, and (3) hypothesized key drivers of QOL. One hundred seventy-three patient-parent pairs (40 defibrillators/133 pacemakers) were included. Compared with healthy controls, patients with devices and their parents reported significantly lower Pediatric Quality of Life Inventory scoring. Similarly, compared with patients with mild forms of CHD, parents and patients with devices reported significantly lower Pediatric Cardiac Quality of Life Inventory scores and were similar to patients with more severe CHD. Key drivers of patient QOL were presence of implantable cardioverter-defibrillator and CHD. For patients, self-perception was a key driver of lower QOL, whereas for parents behavioral issues were associated with lower QOL.

CONCLUSIONS: Patient QOL is significantly affected by the presence of cardiac rhythm devices. Whether these effects can be mitigated through the use of psychotherapy needs to be assessed.

Author List

Czosek RJ, Bonney WJ, Cassedy A, Mah DY, Tanel RE, Imundo JR, Singh AK, Cohen MI, Miyake CY, Fawley K, Marino BS

Author

Anoop K. Singh MD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Arrhythmias, Cardiac
Child
Cross-Sectional Studies
Defibrillators, Implantable
Female
Heart Diseases
Humans
Male
Pacemaker, Artificial
Parents
Quality of Life
Retrospective Studies
Self Concept