Impact of Cardiac Devices on the Quality of Life in Pediatric Patients
Background—Cardiac rhythm devices are increasingly utilized in the pediatric population though their impact on QOL is poorly understood. The purpose of this study was to compare quality of life (QOL) scores between pediatric device patients, healthy controls, and congenital heart disease (CHD) patients, and determine the key drivers of QOL in pediatric device patients.
Methods and Results—Multi-center, cross-sectional study at 8 pediatric centers of subjects 8-18 years with either a pacemaker or defibrillator. Patient-parent pairs completed the Pediatric Quality of Life Inventory (PedsQL) and Pediatric Cardiac Quality of Life Inventory (PCQLI). QOL outcomes in device patients were compared to healthy controls and patients with various forms of CHD. Structural Equation Modeling was used to test for differences in PCQLI scores between: 1) device-type; 2) presence of CHD; and 3) hypothesized key drivers of QOL. 173 patient-parent pairs (40 defibrillators/133 pacemakers) were included. Compared to healthy controls, patients with devices and their parents reported significantly lower PedsQL scoring. Similarly, compared to patients with mild forms of CHD, parents and patients with devices reported significantly lower PCQLI scores and were similar to patients with more severe CHD. Key drivers of patient QOL were presence of ICD and CHD. For patients, self-perception was a key driver of lower QOL, while for parents' behavioral issues were associated with lower QOL.
Conclusions—Patient QOL is significantly affected by the presence of cardiac rhythm devices. Whether these effects can be mitigated through the use of psychotherapy needs to be assessed.
- Received April 5, 2012.
- Accepted October 17, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited