Abstract:
Background: Cardiac implantable electronic device is a term that encompasses
pacemakers, implantable cardioverter defibrillators and cardiac resynchronization therapy.
These lifelong devices are established treatments and are known to improve survival in
patients with cardiac arrhythmias (1,2), however, in any chronic therapy or illness entails
physical, psychological and social challenges that can interfere with daily activities of a
patient and influence their quality of life (3). Individual’s own perception of their health
and illness plays a critical role to help health professionals to gain insight on the
effectiveness of therapy and challenges faced by the patients in order to improve care (4).
Objectives: To assess the QOL and its associated factors among patients with cardiac
implantable electronic devices implanted at JKCI.
Methodology: A hospital based cross-sectional study, involving patients with cardiac
implantable electronic devices implanted at JKCI was conducted from October 2019 to
January 2020. All patients who were registered to undergone device insertion were
interviewed after informed consent was obtained. A standardized generic Kiswahili version
questionnaires Short form-36 (SF-36) and a disease specific AQUAREL were filled.
Baseline socio-demographic and clinical characteristics were collected from patient’s files.
Statistical analysis was conducted on SPSS 23.0 and a p-value of <0.05 was considered
significant. Ethical clearance was obtained from the MUHAS directorate of research and
publications.
Results: There were 171 patients, 52% were females and 75.4% were ≥60years. The QOL
was overall good as patients scored above 50 for most domains on the SF-36 and
AQUAREL except on social functioning domain on SF-36 with. Age was negatively
associated with general health (R²=75.0%, p≤0.001), increasing implant years was
positively associated with physical functioning (R²=22%, P≤0.001), role physical
(R²=5.6%, P≤0.001), bodily pain (R²=12%, P≤ 0.002), emotional health (R²=74%,
P<0.002) and vitality (R²= 19.6% p<0.018). On mental health domains on SF-36, female
sex compared to male sex (R²= 18.4%, P<0.025) as well as widow status compared to
married status (R²= 9.2%, P<0.05) were negatively associated with mental health.
Conclusion: Patients with cardiac implantable electronic devices at JKCI had overall good
QOL however, had poor social functioning. As number of years post implant increases, the
QOL gets better and with old age the QOL starts to decline. Female patients and widows
have poor mental health compared to male patients and married respectively. In terms of
disease-specific effects with reference to chest discomfort, dyspnea and arrhythmia most
patients had high scores on AQUAREL indicating to be free of symptoms.
