Page 90 - JCBP-2-3

Journal of Clinical and
Basic Psychosomatics Psychological changes in patient with ICD

However, the ECG manifestations tend to be spontaneous, had been implanted with ICD for secondary prevention
intermittent, and dynamic, usually occurring when vagal due to resuscitation after cardiac arrest. The patient
activity is predominant. Moreover, the diagnosis of ERS developed anxiety and depression after frequent ICD
can only be established by reviewing after the occurrence shocks. In this paper, we discuss the psychological state of
of clinical events. the patient implanted with ICD for shock therapy and the

The currently available treatments for ERS entail corresponding treatment measures employed to reduce
conservative measures for asymptomatic patients, including anxiety and depression experienced by the patient.
fever management and infection prevention. Isoproterenol 2. Case presentation
is used in the patients in acute phase, and quinidine is
utilized in chronic phase to control the episodes of ERS- A 49-year-old male with episodic syncope lasting 5 years was
related ventricular fibrillation (VF). It is currently believed admitted to the Wuxi People’s Hospital, China, and closely
that implantable cardioverter defibrillator (ICD) can be monitored for 1 day. In April 2017, the patient suffered
used for the primary and secondary prevention of fatal from a sudden syncope without any triggers, accompanied
3
arrhythmia events and SCD in patients with ERS. However, by limb convulsions and loss of consciousness, and woke up
such implantable electronic devices are not without risks, spontaneously after 5 min. After that incident, the patient
and patients may experience surgical and post-operative experienced syncope for an additional three times. In the
complications during ICD implantation. In addition, ICD latest syncope incident, the patient lost consciousness
automatically delivering shocks after the identification of when he was being sent to the emergency department
ventricular arrhythmic events also has a negative impact on of the hospital. The emergency ECG monitoring showed
the mental health of patients. ICD shocks, either appropriate that the patient had VF. Cardiopulmonary resuscitation,
or inappropriate, have been shown to be associated electrical defibrillation, and tracheal intubation were
with anxiety and depression disorders in both patient subsequently applied. The patient was reexamined using
populations with congenital and acquired heart diseases. ECG, which indicated bradycardia (Figure 1A). A range of
4
Anxiety and depression are considered to be associated blood tests were conducted, showing low serum potassium
with an increased risk of death and VF in patients with ICD, level, elevated levels of cardiac enzymes and troponin
independent of traditional risk factors. 5 I, and brain natriuretic peptide level at 1829.00 pg/mL.
In this case report, we present a middle-aged man Cardiac color Doppler ultrasound showed that the size and
exhibiting early repolarization, as indicated by ECG, who function of each cardiac chamber were normal (Table S1).

A C

B D

Figure 1. Multiple electrocardiogram manifestations. Red arrow points to area where J point is visible, followed by oblique elevation of the ST segment.

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