CONGRESS ABSTRACT

Background: The wide prevalence in cardiac device implantation implies the need for a comprehensive evaluation of their impact on health-related quality of life (HR-QoL) and psychological outcomes. The aim of this systematic review was to provide a literature overview about this issue. Methods: A systematic review of the literature has been performed by considering articles published between 2000-2024. The databases searched were PubMed, EMBASE, CINAHL, Web of Science, and the Cochrane Database of Systematic Reviews. Of the 122 records, 28 studies were selected: 8 focused on pacemakers, 5 on cardiac resynchronization therapy (CRT), and 15 on implantable cardioverter defibrillators (ICDs). Both HR-QoL and psychological outcomes were evaluated. Results: Pacemaker implantation showed consistent improvement in HR-QoL, particularly in younger patients without comorbidities. Leadless pacemakers seemed to demonstrate better outcomes than conventional devices. ICD recipients showed mixed results, with newer studies indicating QoL improvements, particularly with CRT-D devices. ICD shocks (>5) were associated with decreased QoL and increased anxiety. Subcutaneous ICDs showed comparable or better outcomes than transvenous ICDs. CRT demonstrated immediate QoL improvements which were consistent even at two years’ follow-up post-implantation. Women, younger patients, and those with Type D personality showed poorer device acceptance across all categories. Conclusions: Cardiac device implantation generally improved or, at least, retained HR-QoL in most patients. Psychological outcomes might significantly vary in relation to device type, patient characteristics, and adverse events (particularly ICD shocks). New technologies have shown promising results. Future research should focus on identifying high-risk patients for poor device acceptance and developing targeted psychological support strategies. Key words: health-related quality of life; psychological outcomes; pacemaker; implantable cardiac defibrillator; cardiac resynchronization therapy.