Psychiatric Co-morbidities in Pediatric Population with implantable Cardiac Devices

Abstract

SUMMARY C ardiac devices are effective long-term treatment for a variety of brady and tachy arrhythmias. By providing an appropriate heart rate and heart rate response, cardiac pacing can re-establish effective circulation and more normal hemodynamics that are compromised by a slow heart rate. Also by giving internal shocks or anti tachycardia pacing, ICDs can terminate life threatening arrhythmias. Since children are paced for a lifetime, they are more prone to a higher incidence of long-term adverse events. Our study was conducted on 60 children with cardiac devices aged from 8-17 years (mean 11.8±3); (30 with structurally normal heart and 30 with structurally abnormal heart), comparing this study group with another 30 healthy controls of the same age group regarding depressive symptoms, anxiety symptoms and parents’ quality of life. The goal of the study is to determine the impact of cardiac devices on child psychology (anxiety and depression) and parents’ quality of life. We used three Arabic validated psychiatric tools at the current study: • Child depression inventory (CDI) to assess depressive symptoms in children. • Child modified form of Taylor Manifest Anxiety Scale (TMAS) to assess anxiety symptoms in children • PCASEE model to assess parents' quality of life. Comparison between the current three studied groups revealed higher levels of depression and anxiety in patients with structurally abnormal hearts than patients with structurally normal heart or healthy controls. Parents of children with structurally abnormal heart tend to have lower quality of life than parents of children with structurally normal heart or healthy controls. Furthermore, patients with implantable cardioverter defibrillators were found to have more levels of anxiety than those with structurally abnormal heart and had permanent pacemakers. Further studies are still needed with larger number of subjects to ascertain the impact of cardiac devices on children and their families.