Do patients accept Implantable atrial defibrillation therapy? Results from the patient atrial shock survey of acceptance and tolerance (PASSAT) study

Patient Acceptance of ICD.Introduction: The Medtronic Jewel AF 7250 is an implantable cardioverter defibrillator with atrial and ventricular therapies (ICD-AT). The ICD-AT is effective in managing atrial tachyarrhythmias (atrial fibrillation [AF]), but patient acceptance remains an issue. This aim of this study was to measure ICD-AT acceptance. Methods and Results: ICD-AT acceptance was evaluated in 96 patients enrolled in the "Jewel AF-AF-Only Study" for greater than or equal to3 months of follow-up (mean 19 months). Patients were mostly men (72%; age 65 12 years). Clinical data and a written survey (75% response rate) were used to quantify demographics, AF frequency and symptoms, atrial defibrillation therapy, quality of life (QOL), psychosocial distress, and ICD-AT therapy acceptance. From implant to survey, AF symptom and severity scores decreased by 18% (P < 0.05), and QOL (SF-36) scores increased by 15 % to 50 % (P less than or equal to 0.05). ICD-AT therapy acceptance was high, with 71.3 % of patients scoring in the 75th percentile on the Florida Patient Acceptance Survey. ICD-AT acceptance was correlated with the Physical Component Scale and Mental Health Component Scale scores of the SF-36 (r = 0.28 and 0.35, respectively). ICD-AT acceptance was negatively correlated with depressive symptomatology (r = -0.59), trait anxiety (r = -0.48), illness intrusiveness (r = 4.55), and AF symptom and severity scores (r = -0.26). ICD-AT acceptance did not correlate with preimplant cardioversions, number of atrial shocks, AF episodes detected by the device, or device implant duration. Conclusion: Most patients accepted ICD-AT therapy. Patients were more likely to accept ICD-AT if they had less psychosocial distress, greater QOL, and lower AF symptom burden.