植入式心律转复除颤器术后焦虑研究的进展

Study of Postoperative Anxiety with Implantable Cardioverter Defibrillator

目前,植入式心律转复除颤器是防治心源性猝死的有效措施。尽管它提高了患者的生存效益,但由于心理及生物等各种因素,部分患者出现了焦虑症状,尤其是经历电击的患者。焦虑症状与不良心脏结局相关,降低了患者的生活质量,并增加再入院率和医疗费用,从而降低了植入式心律转复除颤器的治疗效益。此外焦虑也是除颤器电击治疗的触发因素,电击、焦虑互为因果形成恶性循环。尽管认知行为疗法治疗植入除颤器患者的焦虑症状有效,但临床依从性差,而网络干预途径有望成为新趋势,但尚未完善。因此心内科医师有必要对植入除颤器患者术后的焦虑症状进行筛查,并详细记录他们的心脏病史及除颤器随访记录,以便分析植入除颤器后焦虑相关的因素并进行干预,提高植入除颤器患者的治疗效益。

Currently,implantable cardioverter defibrillator is an effective measure to prevent sudden cardiac death.Although it improves the survival benefit of patients,some patients experience anxiety symptoms,especially those who experience electric shocks,due to various psychological and biological factors.Anxiety symptoms are associated with poor cardiac outcomes,reducing the quality of life of patients and increasing readmission rates and healthcare costs,thereby reducing the therapeutic benefit of implantable cardioverter defibrillator.In addition,anxiety is a trigger for defibrillator shock therapy,and shock and anxiety are mutually reinforcing in a vicious cycle.Although cognitive behavioral therapy is effective in treating anxiety in patients with implanted defibrillators,clinical adherence is poor,and web-based intervention is a promising new trend that has not yet been perfected.Therefore,it is necessary for cardiologists to screen defibrillator implantation patients for postoperative anxiety symptoms and record their cardiac history and defibrillator follow-up records in order to analyse the factors related to anxiety after defibrillator implantation and intervene in order to improve the benefits of treatment for defibrillator implantation patients.