Shock-related anxiety and sexual function in adults with congenital heart disease and implantable cardioverter-defibrillators

BACKGROUND An increasing number of adults with congenital heart disease (CHD) require implantable cardioverter-defibrillators (ICDs), yet little is known about their impact on psychological wellbeing and sexual function. OBJECTIVE To assess shock-related anxiety in adults with CHD and its association with depression and sexual function. METHODS A prospective, multicenter, cross-sectional study was conducted on adult patients with CHD with (ICD+) and without (ICD) ICDs. The Florida Shock Anxiety Scale was administered to patients with ICD+ and the Beck Depression Inventory-II to all patients. Men competed the Sexual Health Inventory for Men, and women competed the Female Sexual Function Index. RESULTS A total of 180 adults with CHD (ICD+: n = 70; ICD : n = 110; median age 32 years [interquartile range 27-40 years]; 44% women) were enrolled. The complexity of CH D was classified as mild in 32 (18%), moderate in 93 (52%), and severe in 54 (30%) subjects. In ICD recipients, a high leve l of shock-related anxiety was identified (Florida Shock Anxiety Scale score 16; interquartile range 12-23.5), which was slightly higher than the median score for ICD recipients in the genera l population (P =.057). A higher leve l of shock-related anxiety was associated with poorer sexual function scores in both men (Spearman's p =.480; P <.001) and women (Spearman's p =.512; P <.01). It was also associated with self-reported depressive symptomatology (Spearman's p =.536; P <.001). CONCLUSIONS Adults with CHD and ICDs demonstrate a high level of shock-related anxiety, which is associated with lower sexual functioning scores in men and women. These results underscore the need for increased clinical attention related to ICD-related shock anxiety and impaired sexual function in this population.