Influence of anxiety/depression on health related quality of life of patients with various pacing modes

Background The thesis is to study the influence of anxiety/depression on health related quality of life （HRQoL） of patients with various pacing modes a month after they have had a pacemaker implanted. Methods HRQoL was assessed consecutively in patients （50 men, 48 women, mean age 52.7±14.1 years） with implanted pacemaker （PM） from June to December 2009 in our hospital （22 patients received VVI pacemaker, 26 received VVIR pacemaker, 26 received DDD pacemaker, 24 received DDDR pacemaker）. HRQoL was measured by the SF-36 and Aquarel questionnaires, anxiety by Zung anxiety scale （SAS） and depression by Zung depression scale （SDS）. Results Patients with rate-adaptive pacing had higher scores in SF-36 scales （health perception, vitality, social functioning and mental health） and Aquarel （chest pain, dyspnea and arrhytmia）; they also presented lower degree of anxiety and depression compared with those with non-rate-adaptive pacing. Differences were shown only in the group with dual chamber pacemakers, but not in the group with single chamber pacemakers. Significant differences were observed between patients with single chamber and dual chamber PM in rate-adaptive pacing. There was a strong correlation between the degree of anxiety and depression and the HRQoL for pacemaker patients. Conclusion Dual chamber rate-adaptive pacing offers better HRQoL and psychological profile than dual chamber non-rate-adaptive pacing. Significant improvement in five SF-36 subscales was observed with DDDR pacing compared with VVIR pacing. Anxiety and depression are important factors in the HRQoL of patients with implanted pacemakers. Early detection and intervention in patients with psychological problems are imperative.