Psychological Well-Being and Health-Related Quality of Life Following Ventricular Tachycardia Ablation, A Prospective Study
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Ventricular tachycardia (VT) is a debilitating and potentially fatal cardiac arrhythmia. Implantable cardioverter defibrillators (ICD) are first-line therapy for treatment of VT. However, ICD shocks can have a profound impact on psychological well-being and health-related quality of life (HRQoL). Catheter ablation of VT is a novel procedure intended to reduce VT recurrence, medication use, and ICD shocks. To-date, there is a paucity of research examining psychological well-being and HRQoL in ICD recipients undergoing VT ablation. This case-control prospective study aimed to 1) examine predictors of post-traumatic stress disorder (PTSD) symptoms, and symptoms of anxiety, and depression in ICD recipients following VT ablation and 2) evaluate whether VT ablation is associated with greater improvement in HRQoL, and symptoms of anxiety, depression, and PTSD. Hypothesis 1 assessed whether higher optimism, self-efficacy, and positive health expectations at baseline predict improvement in symptoms of PTSD, anxiety, and depression at six-month follow-up. Hypothesis 2 tested whether HRQoL, depression, anxiety, and PTSD symptoms improve more over six-month follow-up in ICD recipients who underwent VT ablation as compared to ICD recipients who did not. Measures of PTSD, anxiety, depression, and HRQoL were administered at baseline and follow-up. Measures of optimism, positive health expectations, and self-efficacy were administered at baseline. Hierarchical regression analyses were employed to assess the hypotheses. Results of Hypothesis 1 showed that higher self-efficacy at baseline predicts improvement in symptoms of anxiety and PTSD at follow-up, over and above group membership. Contrary to hypothesis, optimism and positive health expectations did not predict improvement in psychological well-being. Contrary to Hypothesis 2, between-group differences were not detected on HRQoL, symptoms of anxiety, depression, or PTSD symptoms. However, ICD participants who underwent VT ablation showed improvement in mental health HRQoL and symptoms of PTSD, while control participants showed improvement in domains of anxiety and PTSD. These findings lend support to the protective function of self-efficacy, particularly with respect to anxiety-based outcomes. HRQoL benefits of VT ablation were not detected, although the pattern of within group improvements hint at potential benefits related to anxiety and trauma symptoms.