Tehran University Medical Journal

Background: Several studies that have evaluated psychological and counseling interventions suggest that a proactive approach may be effective in preparing patients for the experience of living with an implantable cardioverter-defibrillator (ICD). The purpose of this study was to develop and assess cognitive and behavioral interventions in reducing stress and anxiety and improving quality of life.

Methods: One hundred Patients with ICD in Shariati and Imam Khomeini Hospital in Tehran, Iran during 2009- 2010 were divided randomly into two groups to undergo cognitive and behavioral interventions (case group) or serve as the control group. The patients in the case group were received relaxation, cognitive and ICD alarm trainings three times during the study period. Routine care was the same in both groups after ICD implantation. We evaluated anxiety and depression by, respectively, Beck anxiety and Beck depression inventories in the two groups before and after ICD implantation. Quality of life was also evaluated by SF-36 instrument before and after the interventions. The results were later compared between the two groups.

Results: Beck scores for anxiety in the case and control groups before the interventions were 24.9±15.5 and 24.2±15.8 (P=0.590), respectively and after six months they were 13.5±8.3 and 17.9±10.1 (P=0.005), respectively. Beck scores for depression in the case and control groups before the interventions were 17.7±9.8 and 18.4±10.6 (P=0.590), respectively and after six months the scores, respectively, were 13.5±8.3 and 17.9±10.1 (P=0.005).

Conclusion: It seems that psychological interventions can reduce anxiety and depression after ICD implantation. Further studies with more sample sizes are necessary for the final judgment.