TY - JOUR
T1 - Improving the care for female subcutaneous ICD patients
T2 - A qualitative study of gender-specific issues
AU - van der Stuijt, Willeke
AU - Quast, Anne-Floor B. E.
AU - Baalman, Sarah W. E.
AU - Olde Nordkamp, Louise R. A.
AU - Wilde, Arthur A. M.
AU - Knops, Reinoud E.
N1 - Copyright © 2020. Published by Elsevier B.V.
PY - 2020/10/15
Y1 - 2020/10/15
N2 - 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.
AB - 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.
KW - Adult
KW - Defibrillators, Implantable
KW - Female
KW - Humans
KW - Middle Aged
KW - Netherlands/epidemiology
KW - Retrospective Studies
KW - Subcutaneous Tissue
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85087019957&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcard.2020.05.091
DO - https://doi.org/10.1016/j.ijcard.2020.05.091
M3 - Article
C2 - 32512063
SN - 0167-5273
VL - 317
SP - 91
EP - 95
JO - International journal of cardiology
JF - International journal of cardiology
ER -