Past Issues
Posttraumatic Stress Disorder after Delivering of Shocks by an Implantable
Cardioverter-defibrillator
Hung-Wei Chen, Te-Jen Lai, Chia-Ming Chang, William R. Bell
Objective: The implantable cardioverter defibrillator (ICD) is a device that
continuouslymonitors the electrical activity of the heart and can terminate arrhythmias
via defibrillation. We report a case of posttraumatic stress disorder (PTSD)
after ICD shocks were delivered by the device due to an episode of arrhythmia.
Case report: A 38 year-old man had suffered from sudden onset of cardiac arrest
8 years prior to this admission, when emergent resuscitation with defibrillation had
saved his life. Due to the uncontrollable ventricular arrhythmia which began 7
years after the initial cardiac event and occurred repeatedly over 2 days, malignant
ventricular arrhythmia was diagnosed and an ICD was implanted. Three months
later, arrhythmia recurred and successive ICD shocks were delivered by the device
with resulting stabilization. However, he developed serious anxiety, depression,
and PTSD was diagnosed as a result of these events based on symptoms including
re-experience, avoidance and hyperarousal. Antidepressants and cognitive behavior
therapy were given and the symptoms improved. Conclusion: Awareness of
the risk of PTSD in patients with an ICD after the delivery of shocks to correct arrhythmia
is needed when using this device to treat patients with cardiovascular disease.
continuouslymonitors the electrical activity of the heart and can terminate arrhythmias
via defibrillation. We report a case of posttraumatic stress disorder (PTSD)
after ICD shocks were delivered by the device due to an episode of arrhythmia.
Case report: A 38 year-old man had suffered from sudden onset of cardiac arrest
8 years prior to this admission, when emergent resuscitation with defibrillation had
saved his life. Due to the uncontrollable ventricular arrhythmia which began 7
years after the initial cardiac event and occurred repeatedly over 2 days, malignant
ventricular arrhythmia was diagnosed and an ICD was implanted. Three months
later, arrhythmia recurred and successive ICD shocks were delivered by the device
with resulting stabilization. However, he developed serious anxiety, depression,
and PTSD was diagnosed as a result of these events based on symptoms including
re-experience, avoidance and hyperarousal. Antidepressants and cognitive behavior
therapy were given and the symptoms improved. Conclusion: Awareness of
the risk of PTSD in patients with an ICD after the delivery of shocks to correct arrhythmia
is needed when using this device to treat patients with cardiovascular disease.
| Key Word | implantable cardioverter defribillator, PTSD, anxiety |
|---|