Psychological trauma and health-related quality of life following ventricular tachycardia ablation

BACKGROUND: An implantable cardioverter defibrillator (ICD) is a first-line treatment for ventricular tachycardia (VT); however, ICD shocks are associated with poorer health-related quality of life (HRQoL) and psychological well-being. Clinically, HRQoL and psychological trauma of ICD patients are often severe enough to be offered VT ablation. HRQoL and especially psychological trauma levels have not been evaluated in ICD recipients who underwent a VT ablation as compared to those ICD recipients who were treated medically. METHODS: 61 participants were enrolled. Participants completed measures of global HRQoL SF-36 Mental Health Component Summary (MCS) and Physical Component Summary, depression and anxiety Hospital Anxiety and Depression Scale (HADS-A) and trauma Impact of Events Scale-Revised (IES-R) at baseline (recruitment) and 6-months follow-up. Hierarchical regression analyses were employed to assess the hypothesis. RESULTS: Regression analyses showed no significant between-group differences on outcome measures. Within-group effects suggested that participants who underwent an ablation improved in mental health HRQoL MCS (p = .002), IES-R Total (p = .005), Intrusion (p = .005) and Hyperarousal (p = .007) subscales. Those who did not undergo an ablation had no improvement in HRQoL, but improved in HADS-A (p = .02), IES-R Total (p = .04), Intrusion (p = .04) and Hyperarousal (p = .02). CONCLUSION: Contrary to hypothesis, significant differences on outcome measures over follow-up were not detected between-groups. Within-group effects suggest better outcomes on HRQoL and emotional distress in ICD recipients who underwent an ablation than those who did not. Lack of between-group differences underscores the need for further study to better understand if and how ablation might improve HRQoL and distress within the ablation subgroup.