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Defibrillators Don't Diminish Quality of Life


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Something else to consider was the patients' sobering introduction to the study, Mark said. "They were told they faced sudden death. That is a conversation they probably had not had before, being told there is a good chance you could just keel over one day with no significant warning," he noted.

Actually getting a heart-restarting shock made people feel worse, Mark noted. "We don't know if it was the shock itself or the condition that created the need for the shock," he said.

The findings are published in the Sept. 4 issue of the New England Journal of Medicine.

Text Continues Below



There were serious worries about the effect of implanted defibrillators on recipients' feelings of well-being when the devices were first introduced about two decades ago, said Dr. Marie-Noelle Langan, an electrophysiologist at Lenox Hill Hospital in New York City.

"There were definite reasons for worry," Langan said. "First, a defibrillator is a physical reality. It cannot be ignored as a medication can be. Second, the shocks delivered by early models could be very bothersome."

Worries have eased as the technology has advanced, she said. "Defibrillators have become much more sophisticated," Langan said.

Another paper in the same issue of the journal showed vividly that getting a defibrillator shock is grounds for worry. In a study of 829 heart-failure patients with implanted defibrillators, researchers found that 269 received at least one shock over a period of 45.5 months. Of these, 128 got shocks that were medically warranted, 87 got "inappropriate" shocks, and 54 received both kinds.

Getting an appropriate shock was a serious sign of trouble, increasing the risk of subsequent death more than fivefold, compared to not getting a shock. But even an inappropriate shock nearly doubled the risk of death. For those who lived longer than 24 hours after an appropriate shock, the risk of death during the study was nearly tripled, the researchers found.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 9/3/2008

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SOURCES: Daniel B. Mark, M.D., M.P.H., professor, medicine, Duke University Medical Center, Chapel Hill, N.C.; Jeanne E. Poole, M.D., professor, medicine, University of Washington, Seattle; Marie-Noelle Langan, M.D., electrophysiologist, Lenox Hill Hospital, New York City; Sept. 4, 2008, New England Journal of Medicine


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