Defibrillators Don't Diminish Quality of Life

By Ed Edelson
HealthDay Reporter
Wednesday, September 3, 2008; 5:00 PM

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WEDNESDAY, Sept. 3 (HealthDay News) -- Getting an implanted defibrillator that can deliver a shock to restart a failing heart not only prolongs life but also doesn't appear to detract from the quality of life, a new study finds.

The study was done "not only to see whether or not lives would be saved but also the quality of those lives," said lead author Dr. Daniel B. Mark, a professor of medicine at Duke University Medical Center. "We wanted to know whether patients who will have these devices for many years would be satisfied with them."

Mark and his colleagues reviewed results of a 30-month study whose primary purpose was to measure whether implanted defibrillators reduced deaths among 2,521 people with heart failure, a life-threatening condition in which the heart progressively loses the ability to pump blood. All the participants got standard drug treatment for the condition. And one-third of them had defibrillators implanted, one-third were also given the rhythm-restoring drug amiodarone, and one-third got a placebo.

All the participants had about the same scores on tests of psychological well-being at the start of the study. Subsequent interviews found that those with the defibrillators had somewhat higher scores at three and 12 months, and there were no differences in psychological outlook at 30 months.

"Keeping in mind that they all have chronic heart failure, there is no evidence that defibrillators make anything worse," Mark said.

But caution is needed in interpreting the study, he said, because it couldn't achieve the desired goal of being "double-blind" -- with neither patient nor doctor knowing who was getting which treatment. The early positive reports by those with defibrillators "could have been due to the fact that they got some positive feedback from having been selected for the defibrillator arm of the trial," he said.

Something else to consider was the patients' sobering introduction to the study, Mark said. "They were told they faced sudden death. That is a conversation they probably had not had before, being told there is a good chance you could just keel over one day with no significant warning," he noted.