The Psychological Impact of Implantable Cardioverter Defibrillators: A Narrative Review
Bibliographic record
Abstract
Implantable cardioverter defibrillators (ICDs) are critical to the prevention of sudden cardiac death caused by life-threatening arrhythmias such as ventricular tachycardia and fibrillation. While their clinical value is well-established, the psychological impact of living with an ICD remains underrecognized. Patients often experience anticipatory anxiety, depression, Post-Traumatic Stress Disorder (PTSD), and reduced quality of life. These challenges can begin before implantation, persist after both appropriate and inappropriate shocks, and be worsened by fears of device malfunction, recalls, or cybersecurity risks. Many patients alter postimplantation behaviors, avoiding physical activity and reporting diminished trust in medical technology. The burden is especially significant in children, alongside those who experience multiple or unnecessary shocks. Despite increased awareness, mental health care remains poorly integrated into cardiology. Cognitive Behavioural Therapy (CBT), structured patient education, and transparent communication around device updates and recalls have shown effectiveness. In conclusion, addressing this gap is essential to improving outcomes and quality of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".