The implantable cardioverter defibrillator (ICD) is the mainstay of treatment for the prevention of sudden cardiac death, but is associated with a number of treatment-related challenges to patients, including expanding indications, device malfunctioning, and ICD shocks.
The majority of ICD patients seem to cope well with these challenges and preserve their pre-implantation level of functioning. The subset of patients (i.e., 25%) who face adjustment difficulties need to be identified via standardised screening, as psychological distress not only influences quality of life but also increases the risk of ventricular tachyarrhythmias and mortality in ICD patients. These patients are likely to benefit from a multi-factorial intervention that includes a combination of cardiac rehabilitation, psycho education, stress management, and counselling.