Insights into transitioning to life with an implantable cardioverter defibrillator: facing the future

Abstract

Background/Aims: An implantable cardioverter defibrillator (ICD) can deliver a shock that converts a dangerously abnormal heart rhythm into a safe rhythm, preventing a sudden cardiac death. However, the transition from life without an ICD to life with one can be challenging. This study aimed to explore how patients perceived the transition process to life with an ICD. Methods: This qualitative descriptive study was conducted with 10 patients with ICDs, recruited from a tertiary hospital in the Republic of Ireland. A semi-structured interview guide was used to conduct in-person interviews at the end of 2016. The transcripts were thematically analysed, with transition theory being used as a framework to support the process. Results: Participants described how the ICD meant that they had to adapt to a new way of living, with physical, psychological and lifestyle adjustments. The transition process was neither immediate nor linear. Fear of defibrillation and receipt of shocks caused feelings of vulnerability, while the loss of a driving license was perceived as a threat to independence. Conclusions: Coping with the aftermath of defibrillator implantation is contingent on education and the level of support offered to patients. Nurses should strive to identify patients' coping and transitioning skills, as they are ideally positioned to initiate timely discussions that are tailored to the individual's needs and capacity.