Health-related quality of life in a large cohort of patients with cardiac implantable electronic devices A registry-based study.

Aim: The association of cardiac implantable electronic devices (CIED), namely pacemaker (PM), implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy with (CRT-D) or without defibrillator (CRT-P) with health-related quality of life (HRQoL) is lacking.

Methods and results: Data from the Swedish Pacemaker and ICD Registry collected from January 2019 to February 2022 was used to analyze the responses to the European Quality of Life-5 Dimension questionnaire (EQ-5D) before and after one year of the CIED implant. Descriptive analysis was performed using Pearson's chi-square test, the analysis of variance ANOVA, the Kruskal-Wallis test and Wilcoxon signed-rank test when appropriate. A multivariable regression analysis was used to compare the EQ-5D index and EQ-VAS variation after 1 year. Of 1,479 who completed the EQ-5D, 80% had a PM, 10% an ICD, 5% a CRT-P and 6% a CRT-D. The median age was 77 years with females constituting 38% of the PM group and 17% of the ICD group. The EQ-VAS and the EQ-5D index significantly increased after one year from the PM and CRT-P implant (EQ-VAS +2.8, standard deviations (SD) 23 and +5.8, SD 24.9; EQ-5D index +0.019, SD 0.114 and +0.051, SD 0.125) while only the EQ-5D index increased after one year from the ICD implant (+0.002, SD 0.104). After adjusting for age, sex and HRQoL at baseline, the presence of defibrillator was associated with lower EQ-VAS (ICD EQ-VAS variation: -3.4, 95% confidence intervals (CI) -6.7; -0.1 and CRT-D EQ-VAS variation -4.8, 95% CI -8.8;-0.7) and EQ-5D index (ICD EQ-5D index variation: -0.018, 95% CI -0.035; -0.0003 and CRT-D EQ-5D index variation -0.025 95% CI 0.046;0.004) after one year compared to PM.

Conclusion: These findings, showing the HRQoL associated with CIED, are important to support physicians' and pacemaker nurses' care after device implantation by embracing the patients' perspectives.