Intensity of primary emotions in patients after implantation of an implantable cardioverter defibrillator

Background: Experienced emotions can affect the outcome of, and adherence to a cardiac rehabilitation program, and patients coping with an illness. With more awareness of the expressed emotions, health professionals might be better able to understand the reactions of patients and to improve the support needed for coping. Living with an Implantable Cardi-
overter Defibrillator can lead to anxiety and depression. Focus on the intensity of the primary emotions might be a potential to prevent development of these psychological states.

Objectives: The aim of this paper are 1) to describe the intensity of primary emotions in patients after implantation of an Implantable Cardioverter Defibrillator and 2) to compare them with both the intensity of primary emotions in patients with a recent Myocardial Infarction and with a healthy population.

Method: The intensity of primary emotions in patients receiving an Implantable Cardioverter Defibrillator was measured by a survey using the Emotions and Health Scale. The survey was carried out as part of a randomized clinical trial the COPE-ICD trial (ID: NCT00569478) and is regarded as post-hoc explorative analysis. All data were collected from October 2007-November 2009. A total number of 154 patients were needed in the trial. The data collected were compared with secondary data from patients who had recently suffered a Myocardial Infarction and from a healthy population. SPSS version 18.0 was used to analyze the data using t-test, chisquare and F-test.

Results: One hundred and ninety-six patients were invited to fill in the questionnaire. It was completed by 182, a response rate of 93 %. Patients with a newly implanted Implantable Cardioverter Defibrillator experienced an increased intensity of joy, sadness, disgust, anticipation, anger, fear and surprise. No difference was found regarding the intensity of the primary emotions when the group of patients was divided according to occupation or age. A significant increase in the negative emotions sadness, disgust, anger and surprise was observed in women and in patients who receive the Implantable Cardioverter Defibrillator as a secondary prevention. The combination of increased senses of fear and surprise is unique to patients receiving an Implantable Cardioverter Defibrillator. The intensity of the primary emotions in patients with a newly implanted Cardioverter Defibrillator was comparable to the intensity in patients with a myocardial infarction, but the experience of anticipation and fear was markedly increased in patients with an Implantable Cardioverter Defibrillator.
Conclusion: Women and patients who receive an Implantable Cardioverter Defibrillator as secondary prevention experience a significant increase in the negative emotions sadness, disgust, anger and surprise.