„Geschockt“ – Das Leben von ICD-Patient*innen in biopsychosozialer Perspektive

Der implantierte Defibrillator (ICD) kann einen Beitrag zu einem längeren Leben mit guter Lebensqualität leisten. Zugleich stellt neben der jeweiligen Grunderkrankung auch die Therapie derselben für viele Patient*innen eine Herausforderung dar. Insbesondere wiederholte ICD-Schocks können eine erhebliche psychische Belastung sein und zu psychischen Folgestörungen führen, die ihrerseits Lebensqualität und Prognose ungünstig beeinflussen.

Schlüsselwörter

ICD - Schock - psychische Folgen - Behandlung - biopsychosoziale Perspektive

• Literatur

• 1 Deutsche Herzstiftung, Hrsg.. Deutscher Herzbericht – Update 2025. Frankfurt am Main: Deutsche Herzstiftung; 2025. Zugriff am 15. Oktober 2025 unter: https://herzstiftung.de/service-und-aktuelles/publikationen-und-medien/herzbericht
• 2 Ghezzi ES, Sharman RLS, Selvanayagam JB. et al. Burden of mood symptoms and disorders in implantable cardioverter defibrillator patients: a systematic review and meta-analysis of 39.954 patients. Europace 2023; 25: euad130
• 3 Lindekilde N, Skov O, Skovbakke SJ. et al. Anxiety and depression as risk factors for ICD shocks and mortality in patients with an implantable cardioverter defibrillator – A systematic review. Gen Hosp Psychiatry 2022; 78: 96-107
• 4 Ladwig K-H, Köllner V. SOP: Psychokardiologische Betreuung nach Schockabgabe bei ICD-Patienten. Kardiologie up2date 2025; 21: 11-16
• 5 Pedersen SS, Hoogwegt MT, Jordaens L. et al. Pre-implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation. Int J Cardiol 2013; 166: 215-220
• 6 Sears SF, Kirian K. Shock and patient-centered outcomes research: is an ICD shock still a critical event?. Pacing Clin Electrophysiol 2010; 33: 1437-1441
• 7 Pedersen SS, Nielsen JC, Wehberg S. et al. New onset anxiety and depression in patients with an implantable cardioverter defibrillator during 24 months of follow-up (data from the national DEFIB-WOMEN study). Gen Hosp Psychiatry 2021; 72: 59-65
• 8 Dörner M, von Känel R, Pazhenkottil AP. et al. Cross-sectional study on the impact of adverse childhood experiences on psychological distress in patients with an implantable cardioverter-defibrillator. J Psychosom Res 2025; 189: 112033
• 9 Nicmanis M, Chur-Hansen A, Oxlad M. The psychological, social, and quality of life outcomes of people with a cardiac implantable electronic device: an umbrella review. Eur J Cardiovasc Nurs 2024; 23: 441-451
• 10 Schneider LM, Wong JJ, Adams R. et al. Posttraumatic stress disorder in pediatric patients with implantable cardioverter-defibrillators and their parents. Heart Rhythm 2022; 19: 1524-1529
• 11 Whang W, Albert CM, Sears SF. et al. Depression as a predictor for appropriate shocks among patients with implantable cardioverter-defibrillators: results from the Triggers of Ventricular Arrhythmias (TOVA) study. J Am Coll Cardiol 2005; 45: 1090-1095
• 12 Steinberg JS, Arshad A, Kowalski M. et al. Increased incidence of life-threatening ventricular arrhythmias in implantable defibrillator patients after the World Trade Center attack. J Am Coll Cardiol 2004; 44: 1261-1264
• 13 Kamphuis HC, Verhoeven NW, Leeuw R. et al. ICD: a qualitative study of patient experience the first year after implantation. J Clin Nurs 2004; 13: 1008-1016
• 14 Januszkiewicz Ł, Barra S, Providencia R. et al. Long-term quality of life and acceptance of implantable cardioverter-defibrillator therapy: results of the European Heart Rhythm Association survey. Europace 2022; 24: 860-867
• 15 Ein anderer Mensch in 2 Minuten. Herzschrittmacherther Elektrophysiol [Anonym]. 2011; 22: 132-139
• 16 Ladwig KH, Baumert J, Marten-Mittag B. et al. Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: results from the prospective living with an implanted cardioverter-defibrillator study. Arch Gen Psychiatry 2008; 65: 1324-1330
• 17 Edmondson D. An Enduring Somatic Threat Model of posttraumatic stress disorder due to acute life-threatening medical events. Soc Personal Psychol Compass 2014; 8: 118-134
• 18 Sears SF, Rosman L, Sasaki S. et al. Defibrillator shocks and their effect on objective and subjective patient outcomes: results of the PainFree SST clinical trial. Heart Rhythm 2018; 15: 734-740
• 19 Hazelton AG, Sears SF, Kirian K. et al. Cardiology Patient Page. Coping with my partner’s ICD and cardiac disease. Circulation 2009; 120: e73-e76
• 20 Staples JA, Daly-Grafstein D, Robinson I. et al. Motor vehicle crash risk after cardioverter-defibrillator implantation: a population-based cohort study. Heart 2024; 110: 1401-1407
• 21 Varghese S, Geller JC, Ohlow MA. Phantom shocks in implantable cardioverter-defibrillator recipients: impact of education level, anxiety, and depression. Herzschrittmacherther Elektrophysiol 2019; 30: 306-312
• 22 Galo J, Feroze R, Almas T. et al. Understanding Phantom Shocks in Implantable Cardioverter-Defibrillator Recipients. Cureus 2024; 16: e53161
• 23 Gibson DP, Kuntz KK. Managing anxiety in patients with implanted cardiac defibrillators: break the ‘fear of fear’ cycle with ICD-specific tools and cognitive-behavioral therapy. Curr Psychiatr 2007; 6: 17
• 24 Prudente LA, Reigle J, Bourguignon C. et al. Psychological indices and phantom shocks in patients with ICD. J Interv Card Electrophysiol 2006; 15: 185-190
• 25 Prudente LA. Psychological disturbances, adjustment, and the development of phantom shocks in patients with an implantable cardioverter defibrillator. J Cardiovasc Nurs 2005; 20: 288-293
• 26 Nicmanis M, Arcangeli O, Chur-Hansen A. et al. Examining the effectiveness of psychosocial interventions for patients with a cardiac implantable electronic device: a systematic review and meta-analysis. Heart Rhythm 2025; S1547–5271(25)00197–3
• 27 Sears SF, McCrary S, Andrade T. et al. ICD support groups: are they still relevant now?. Heart Rhythm 2025; 6: 874-879
• 28 Olewinski M, Paschke A-M, Mohebb A. et al. An integrative psychosomatic approach to the treatment of patients with cardiovascular diseases: concepts and experiences of a dedicated psychocardiology ward at the University of Göttingen Medical Center. In: Baune BT, Tully PJ. , Hrsg. Cardiovascular Diseases and Depression. Cham: Springer International Publishing; 2016: 493-507
• 29 Jordan J, Titscher G, Peregrinova L. et al. Manual for the psychotherapeutic treatment of acute and post-traumatic stress disorders following multiple shocks from implantable cardioverter defibrillator (ICD). GMS Psychosoc Med 2013; 10: Doc09
• 30 Kinch Westerdahl A, Sjöblom J, Mattiasson AC. et al. Implantable cardioverter-defibrillator therapy before death: high risk for painful shocks at end of life. Circulation 2014; 129: 422-429
• 31 Freemantle M, Murtagh F. Implantable cardioverter defibrillator devices: when, how and who should discuss deactivation with patients: a systematic literature review. BMJ Support Palliat Care 2022; 12: 359-367
• 32 Padeletti L, Arnar DO, Boncinelli L. et al. EHRA Expert Consensus Statement on the management of cardiovascular implantable electronic devices in patients nearing end of life or requesting withdrawal of therapy. Europace 2010; 12: 1480-1489
• 33 Stoevelaar R, Brinkman-Stoppelenburg A, van Bruchem-Visser RL. et al. Implantable cardioverter defibrillators at the end of life: future perspectives on clinical practice. Neth Heart J 2020; 28: 565-570
• 34 Goldstein NE, Mather H, McKendrick K. et al. Improving communication in heart failure patient care. J Am Coll Cardiol 2019; 74: 1682-1692
• 35 Broschmann D, Zelenak C, Herrmann-Lingen C. et al. Zwischen Abschied und Autonomie – Psychokardiologie und Palliativmedizin im Dialog. Z Palliativmed 2024; 25: 255-268