Improving the care for female subcutaneous ICD patients: A qualitative study of gender-specific issues. (15th October 2020)

• Record Type: Journal Article
• Authors: van der Stuijt, Willeke; Quast, Anne-Floor B.E.; Baalman, Sarah W.E.; Olde Nordkamp, Louise R.A.; Wilde, Arthur A.M.; Knops, Reinoud E.
• Is Part Of: International journal of cardiology. Volume 317(2020)
• Page Start: 91
• Page End: 95
• Publication Date: 2020-10-15
• Subjects: Subcutaneous implantable cardioverter defibrillator -- Device therapy -- Gender -- Quality of life -- Outcomes; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2020.05.091
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) consists of a large generator and is implanted near the left breast. This might lead to discomfort and problems with self-perception and sexuality, especially in the female population. We aimed to assess the issues that female S-ICD patients experience and to provide practical guidance for cardiologists and implanters on minimizing these issues. Methods: For this retrospective single-center study, we conducted semi-structured interviews with four female S-ICD patients and processed their experiences into a questionnaire. This consisted of three open questions and 17 statements that participants could answer through a five-point Likert scale. The questionnaire was subsequently sent to all female adult patients who received an S-ICD between February 2009 and November 2018 in our tertiary centre in Amsterdam, the Netherlands. Results: The response rate of the questionnaire was 73%, with 52 female respondents (mean age 47.4 ± 12.5 years, mean time since implant 4.6 ± 3.1 years). Postoperative pain exceeded the expectation of 54% of the respondents. Furthermore, 14 out of 49 respondents (29%) expressed an unpleasant feeling during intimate contact with their sexual partner since the implant. Many women (44%) reported daily discomfort caused by their bra and preferred a more cranial and posterior position of the S-ICD generator. Finally, a smaller design of the generator is desired by a great majority (63%) of female S-ICD patients Conclusion: Female S-ICD patients experience a variety of issues with a substantial impact on their daily life. Most issues that we identified would benefit from adequate counseling and implanter awareness. Highlights: Female patients have a strong wish for a smaller and flatter S-ICD generator. After S-ICD implant, females experience a variety of physical and esthetical issues. With awareness and counseling, health care professionals could amend these issues.