Page 89 - JCBP-2-3

Journal of Clinical and

Basic Psychosomatics

CASE REPORT
Anxiety and depression in a patient with an

implantable cardioverter defibrillator for early
repolarization syndrome: A case report and

clinical discussion

Yue Sun and Zhiming Yu*
Department of Cardiology, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi,
Jiangsu, China

Abstract

Early repolarization syndrome (ERS) was initially thought to be a good prognostic
manifestation detectable by electrocardiogram. In recent years, with the gradual
deepening of research and understanding, ERS is considered to possess malignant
tendency and related to ventricular fibrillation (VF) and sudden cardiac death
(SCD). Implantable cardioverter defibrillator (ICD) is currently the first choice of
treatment used to reduce the risk of potentially life-threatening arrhythmias and
SCD in patients at high risk for ERS. The stress of living with an implanted device
and receiving ICD shock has been noted to exert a psychological toll on patients,
especially those who have previously experienced VF and syncope. The current
case report describes symptoms and signs of a patient with ERS, and discusses the
*Corresponding author: changes of psychological condition after ICD implantation. Moreover, we explored
Zhiming Yu a targeted treatment approach for anxiety and depression in an individual with an
(yuzhimi8660@sina.com) ICD for ERS, which combined medication, cognitive behavioral therapy, and physical
Citation: Sun Y, Yu Z. Anxiety exercise. We believe that the psychological experience of ICD recipients, which is a
and depression in a patient with critical component in designing the biopsychosocial therapeutic approach for this
an implantable cardioverter
defibrillator for early repolarization growing patient population, is worthy of more attention.
syndrome: A case report and
clinical discussion. J Clin Basic
Psychosom. 2024;2(3):2848. Keywords: Cardiology; Early repolarization syndrome; Implantable cardioverter
doi: 10.36922/jcbp.2848 defibrillator; Ventricular fibrillation; Anxiety; Depression
Received: January 30, 2024
Accepted: April 16, 2024
Published Online: July 10, 2024 1. Background
Copyright: © 2024 Author(s). Early repolarization syndrome (ERS) is a diagnosis of exclusion, following the exclusion
This is an Open-Access article
distributed under the terms of the of other common factors that may cause malignant arrhythmias, cardiac arrest,
Creative Commons Attribution and sudden cardiac death (SCD), and electrocardiogram (ECG) can indicate early
License, permitting distribution, repolarization pattern (ERP). At present, the pathogenesis of ESR remains unclear
1
and reproduction in any medium,
provided the original work is but is possibly related to the increase of transient outward potassium current (Ito). The
properly cited. ERP ECG is defined as the elevation of J point which was not less than 0.1 mv, the
1
Publisher’s Note: AccScience formation of J wave, and the elevation of ST segment in a bow-back downward pattern.
Publishing remains neutral with Antzelevitch and Yan have categorized ERP into three types according to the leads of J
regard to jurisdictional claims in wave in ECG (Type 1: I, V4 – V6; Type 2: II, III, aVF; Type 3: I, V4 – V6, II, III, aVF) and
published maps and institutional 2
affiliations. proposed that type 3 is associated with the highest risk of electrical storm occurrence.

Volume 2 Issue 3 (2024) 1 doi: 10.36922/jcbp.2848