***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Significant rates of psychological distress occur in implantable cardioverter defibrillator ( ICD ) patients . Research has demonstrated that women are particularly at risk for developing distress and warrant psychosocial attention . The major objectives were to implement and test the effectiveness of a female-specific psychosocial group intervention on disease-specific quality of life outcomes in outpatient female ICD recipients versus a wait-list control group . METHOD Twenty-nine women were recruited for the study . Fourteen women were r and omized to the intervention group  and participated in a psychosocial intervention focused on female-specific issues ; 15 were r and omized to the wait-list control group .  All women completed individual psychological batteries at baseline and at 1-month follow-up measuring shock anxiety and device acceptance . RESULTS Pre-post measures of shock anxiety demonstrated a significant time by group interaction effect with the intervention group having a significantly greater decrease ( Pillai 's trace = 5.58 , P = 0.026 ) . A significant interaction effect ( Pillai 's trace = 5.05 , P = 0.046 ) was found , such that women under the age of 50 experienced greater reduction in shock anxiety than their middle-aged cohorts . Pre-post measures of device acceptance revealed a significant time by group interaction effect with the intervention group having significantly greater increases ( Pillai 's trace = 5.80 , P = 0.023 ) . CONCLUSIONS Structured interventions for female ICD patients involving ICD-specific education , cognitive behavioral therapy strategies , and group social support provide improvements in shock anxiety and device acceptance at 1-month re- assessment . Young women appear to be an at-risk subgroup of this population and may experience more benefit from psychosocial treatment targeting device-specific concerns Background : While r and omised , controlled trials have established the efficacy of the implantable cardioverter defibrillator ( ICD ) for primary and secondary prevention of life threatening arrhythmias , psychosocial responses remain complex and poorly understood , especially across Europe . There appears to be a greater need to underst and differences in the experience of men and women . Aim : The aim of this prospect i ve study was to explore differences in psychosocial adjustment over a 12 month period following ICD implantation . Methods : Fourteen female and thirty three male device recipients completed a series of question naires over a 12 month period . Instruments included a generic and an ICD specific Quality of Life ( QOL ) measure  and the  State – Trait Anxiety Inventory .  Results : Women reported higher levels of anxiety than men at discharge but over time demonstrated a significant improvement such that at 4 , 8 and 12 months men were more anxious . Women reported significantly poorer emotional wellbeing at discharge , however by 12 months this was significantly improved with no difference in the perceptions held by men and women . Women consistently across the 12 months worried more than men about the impact of the device on appearance . Conclusion : This study confirmed that most individuals adjust positively to the ICD during the first 12 months . Some gender differences in adjustment were evident . Further studies across Europe are warranted to establish gender specific interventions to support men and women as they adapt to life with ICD implants Purpose This study examines the contributions of known predictors of survival and quality of life ( QOL ) to 1-year survival in ICD recipients . Methods This study used the data set from the antiarrhythmia versus implanted defibrillator ( AVID ) controlled clinical trial conducted by the National Institutes of Health , National Heart , Lung , and Blood Institute . The 507 patients r and omly assigned to the ICD treatment were included in the analysis . Patients were mostly male ( 78.3 % ) , with mean age of 64.85 ± 10.81 and mean left ventricular ejection fraction of 32.2 ± 13.45 % . QOL was measured with the medical outcomes study 36-item short form health survey ( SF-36 ) and quality of life index-cardiac version ( QLI-CV ) . Data were analyzed with descriptive statistics and logistic regression . Results Fifty-four ( 10.6 % ) patients died in the first year after ICD implantation . Angiotensin-converting enzyme inhibitor ( ACE ) medication , age , and QLI-CV were significant independent predictors of 1-year survival . The odds of survival of a younger patient with ACE medication and good QOL were approximately three times ( OR = 3.96 ) greater than for an older patient , without ACE medication and with poor QOL . Conclusion Quality of life is an important factor predicting 1-year survival in patients with ICDs . ACE medication and younger age also predict 1-year survival independent of QOL and each other BACKGROUND Sudden death from cardiac causes remains a leading cause of death among patients with congestive heart failure ( CHF ) . Treatment with amiodarone or an implantable cardioverter-defibrillator ( ICD ) has been proposed to improve the prognosis in such patients . METHODS We r and omly assigned 2521 patients with New York Heart Association ( NYHA ) class II or III CHF and a left ventricular ejection fraction ( LVEF ) of 35 percent or less to conventional therapy for CHF plus placebo ( 847 patients ) , conventional therapy plus amiodarone ( 845 patients ) , or conventional therapy plus a conservatively programmed , shock-only , single-lead ICD ( 829 patients ) . Placebo and amiodarone were administered in a double-blind fashion . The primary end point was death from any cause . RESULTS The median LVEF in patients was 25 percent ; 70 percent were in NYHA class II , and 30 percent were in class III CHF . The cause of CHF was ischemic in 52 percent and nonischemic in 48 percent . The median follow-up was 45.5 months . There were 244 deaths ( 29 percent ) in the placebo group , 240 ( 28 percent ) in the amiodarone group , and 182 ( 22 percent ) in the ICD group . As compared with placebo , amiodarone was associated with a similar risk of death ( hazard ratio , 1.06 ; 97.5 percent confidence interval , 0.86 to 1.30 ; P=0.53 ) and ICD therapy was associated with a decreased risk of death of 23 percent ( 0.77 ; 97.5 percent confidence interval , 0.62 to 0.96 ; P=0.007 ) and an absolute decrease in mortality of 7.2 percentage points after five years in the overall population . Results did not vary according to either ischemic or nonischemic causes of CHF , but they did vary according to the NYHA class . CONCLUSIONS In patients with NYHA class II or III CHF and LVEF of 35 percent or less , amiodarone has no favorable effect on survival , whereas single-lead , shock-only ICD therapy reduces overall mortality by 23 percent Background and Research Objective : Although implantations of devices to support cardiovascular function are increasing , little is known about the factors involved in adjusting psychologically to having an implanted device . This study provides factor analysis of the Implanted Device Adjustment Scale ( IDAS ) and self-reported data on quality of life , mood states , and global adjustment . Subjects and Methods : This cross-sectional correlational design study included 174 subjects ( 46 women and 128 men ) . A convenience sample was recruited from electrophysiology practice s in 2 large Midwestern cities . Subjects completed the IDAS , the  SF-36 quality -of-life measure  , the  Profile of Mood States , and a  device adjustment visual analog scale .  Results and Conclusions : The factor analysis produced 4 subscales for the IDAS : fear/anxiety , attitude , preparation , and body awareness . Perceived adjustment was " good " for 89 % of persons and was unrelated to age , sex , type of device , and whether a shock was received . All 4 subscales of the IDAS correlated negatively with adjustment ( higher IDAS score means poorer adjustment ) . The overall IDAS was internally consistent with a Cronbach α = .89 . Adjustment , as measured by the overall IDAS , had a weak but significant relationship with measures of quality of life including the mental component summary scale of the SF-36 ( r = 0.19 ) , but not the physical component summary scale of the SF-36 . All the Profile of Mood States subscales correlated positively with the IDAS subscale anxiety/fear with the exception of vigor/activity which had a negative correlation . No sex differences in total adjustment were seen in this group of patients , although there were differences in body awareness , physical functioning , and fatigue . Although patients with implanted cardioverter defibrillator were more fearful/anxious than patients with pacemaker only , no differences in total adjustment were seen between the 2 groups . A better underst and ing of the experience of adjusting to an implanted device is foundational to the development of appropriate interventions BACKGROUND Patients who survive life-threatening ventricular arrhythmias are at risk for recurrent arrhythmias . They can be treated with either an implantable cardioverter-defibrillator or antiarrhythmic drugs , but the relative efficacy of these two treatment strategies is unknown . METHODS To address this issue , we conducted a r and omized comparison of these two treatment strategies in patients who had been resuscitated from near-fatal ventricular fibrillation or who had undergone cardioversion from sustained ventricular tachycardia . Patients with ventricular tachycardia also had either syncope or other serious cardiac symptoms , along with a left ventricular ejection fraction of 0.40 or less . One group of patients was treated with implantation of a cardioverter-defibrillator ; the other received class III antiarrhythmic drugs , primarily amiodarone at empirically determined doses . Fifty-six clinical centers screened all patients who presented with ventricular tachycardia or ventricular fibrillation during a period of nearly four years . Of 1016 patients ( 45 percent of whom had ventricular fibrillation , and 55 percent ventricular tachycardia ) , 507 were r and omly assigned to treatment with implantable cardioverter-defibrillators and 509 to antiarrhythmic-drug therapy . The primary end point was overall mortality . RESULTS Follow-up was complete for 1013 patients ( 99.7 percent ) . Overall survival was greater with the implantable defibrillator , with unadjusted estimates of 89.3 percent , as compared with 82.3 percent in the antiarrhythmic-drug group at one year , 81.6 percent versus 74.7 percent at two years , and 75.4 percent versus 64.1 percent at three years ( P<0.02 ) . The corresponding reductions in mortality ( with 95 percent confidence limits ) with the implantable defibrillator were 39+/-20 percent , 27+/-21 percent , and 31+/-21 percent CONCLUSIONS Among survivors of ventricular fibrillation or sustained ventricular tachycardia causing severe symptoms , the implantable cardioverter-defibrillator is superior to antiarrhythmic drugs for increasing overall survival Objective : Many patients treated with an implantable cardioverter defibrillator ( ICD )  experience clinical ly significant depression and anxiety after ICD implantation . As ICD use continues to evolve , it is important to underst and the correlates of depression and anxiety to identify patients at greatest risk of poor psychological functioning . Conservation of re sources theory , a general theory of stress , states that people experience greater stress if they perceive that they are losing personal , social , and material re sources . We hypothesized that perceptions of re source loss would be related to symptoms of depression and anxiety after controlling for other known predictors . Methods : One hundred patients treated with an ICD completed st and ardized depression and anxiety question naires along with question naires assessing  social support  ,  physical functioning , and re source loss . Clinical variables for patients were obtained from prospect ively obtained medical records . Results : Over 20 % of the sample exhibited elevated symptoms of depression and anxiety . Patients '  depression levels were associated with poor social support , poor physical functioning , a history of depression , and a greater length of time since ICD implantation . Having experienced one or more clinical ICD shocks was related to depression but not anxiety . Higher levels of perceived re source loss were associated with higher levels of both depression and anxiety after controlling for all other predictors . Conclusions : Re source loss may help to determine psychological distress after ICD implantation . Underst and ing how re source loss contributes to depression and anxiety may help to identify patients at greatest risk of poor psychological functioning and may suggest treatment strategies . ICD = implantable cardioverter defibrillator ; COR = conservation of re sources ; BDI = Beck Depression Inventory ; STAI = State-Trait Anxiety Inventory 
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Results showed that BICs are present in various degrees in the ICD population and can be attributed to the visibility of the ICD ( the scar and bump ) .
Women and younger patients had greater problems with BICs , although men also had concerns .
CONCLUSION BICs were present among ICD patients , but the degree of impact on their lives varied .