Document Detail

Prevention of implantable defibrillator shocks by cognitive behavioral therapy: a pilot trial.
MedLine Citation:
PMID:  16368316     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although psychological stress is known to favor ventricular arrhythmic events, there is no evidence that stress management intervention decreases ventricular electrical instability in implantable cardioverter-defibrillator (ICD) patients. The aim of the study was to determine whether cognitive behavioral therapy (CBT) results in a decrease of arrhythmic events requiring ICD intervention through an improvement in sympathovagal balance. METHODS: Of 253 consecutive ICD patients (age 59 +/- 10 years, 64 men), 70 were randomly assigned to CBT (n = 35) or conventional medical care (n = 35). Measures of heart rate variability, psychological well-being, and quality of life were assessed at baseline, 3 months, and 1 year. The primary outcome was appropriate ICD shock. RESULTS: Although, it was not statistically different, the number of patients requiring shocks was less in the CBT group than in the conventional treatment group. At 3 months, among patients without antiarrhythmic drugs, none of the subjects in the CBT group had experienced arrhythmic events requiring ICD intervention, as compared with 4 in the control group (P < .05). At 12 months, there was no difference in the number of arrhythmic events requiring therapy between the CBT group versus the control group. Among heart rate variability indexes, daytime pNN 50 and nocturnal SDNN improved significantly in the CBT group, as compared with the control group. CONCLUSIONS: By decreasing anxiety and possibly improving sympathovagal balance, cognitive behavior therapy may decrease the propensity for ventricular arrhythmias in ICD patients. However, these effects appear to be limited over time.
Philippe Chevalier; Jean Cottraux; Evelyne Mollard; NanYao Sai; Sophie Brun; Haran Burri; Lioara Restier; Patrice Adeleine
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  151     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-21     Completed Date:  2006-03-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  191     Citation Subset:  AIM; IM    
Cardiology and Intensive Care Department, Hôpital Cardiologique, Lyon, France.
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MeSH Terms
Arrhythmias, Cardiac / prevention & control*
Cognitive Therapy*
Defibrillators, Implantable*
Middle Aged
Pilot Projects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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