skip to main content

ICD-related Psychological Distress — EECC MCQ

Instant feedback + full explanation. One question, done properly.

EasyArrhythmia & ElectrophysiologyICD-related Psychological DistressEECC

A 60-year-old man with an ICD receives multiple appropriate shocks for VT. He reports significant anxiety, sleep disturbance, and fear of future shocks. What psychological support should be offered?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Referral for psychological assessment and cognitive behavioural therapy (CBT) — ICD-related anxiety and PTSD-like symptoms are common (affecting 25-50% of patients) and are associated with worse quality of life and increased mortality

Psychological distress following ICD shocks is a significant and underrecognised clinical problem. Up to 25-50% of ICD patients experience anxiety, depression, or PTSD-like symptoms related to shock experiences or fear of future shocks. The ESC 2022 VA/SCD Guidelines recommend: (1) routine screening for psychological distress in ICD patients; (2) cognitive behavioural therapy (CBT) — the best-evidenced intervention for ICD-related anxiety; (3) ICD-specific support groups; (4) pharmacotherapy (SSRIs if indicated — note QTc monitoring); (5) optimisation of device programming to minimise shocks (higher detection rates, longer detection intervals, anti-tachycardia pacing before shocks). Psychological distress is independently associated with increased mortality (via autonomic dysregulation and catecholamine surges), making it a clinically important comorbidity.

Reference: ESC (2022): VA/SCD Guidelines; EHRA Expert Consensus