MedPath

Positive Therapy for Autonomic Function & Mood in ICD Patients

Not Applicable
Completed
Conditions
Implantable Cardioverter Defibrillator
Ventricular Arrhythmia
Interventions
Behavioral: Quality of Life Therapy (QOLT)
Behavioral: Heart Healthy Education (HHE)
Registration Number
NCT02088619
Lead Sponsor
Medical University of South Carolina
Brief Summary

The purpose of this 2-group randomized clinical trial is to: 1) examine the feasibility and acceptability of a 3-month positive-emotion focused therapy (Quality of Life Therapy) modified specifically for patients with implantable cardioverter defibrillator (ICD); and 2) obtain estimates of effect size for QOLT compared to Heart Healthy Education on the changes in arrhythmia frequency and biomarkers of autonomic function, as well as changes in emotion, mood, and well-being across time (baseline, 3 \& 9-months). It is hypothesized that the QOLT will promote improvements in autonomic function, reduced arrhythmia frequency, and improved psychological well-being.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
29
Inclusion Criteria
  1. Adult men and women (≥18 years of age) who have received an ICD for primary or secondary prevention of sudden cardiac death. All patients will have systolic left ventricular dysfunction due to coronary disease or nonischemic cardiomyopathy. There is no requirement for time since implant;
  2. Score ≥5 on the Hospital Anxiety and Depression Scale (HADS) anxiety or depression scales;
  3. Able to read and write English
  4. Able to commit to the 3-month QOLT/HHE program and 3 assessments over a 9-month duration.
Exclusion Criteria
  1. >5% atrial or ventricular pacing;
  2. Sinus node dysfunction;
  3. Persistent and permanent atrial fibrillation (AF) (h/o of paroxysmal AF will be allowed).
  4. Long QT syndrome; and other channelopathies such as Brugada syndrome;
  5. Hypertrophic cardiomyopathy;
  6. Neurocognitive or cognitive impairments;
  7. Severe psychopathology that warrants intensive treatment;
  8. Participation in another research trial; and
  9. Currently in psychological or psychiatric treatment.
  10. Current psychotropic and cardiac medication prescriptions and usage need to be stable (i.e., no change in type or dosage) for 3-months prior to study enrollment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Quality of Life Therapy (QOLT)Quality of Life Therapy (QOLT)Positive emotion-focused cognitive behavioral psychotherapy
Heart Healthy Education (HHE)Heart Healthy Education (HHE)Heart healthy education program
Primary Outcome Measures
NameTimeMethod
Frequency of arrhythmias between 3-months and 9-months9-months

Total arrhythmia frequencies between 3-months and 9-months will be the sum of non-sustained ventricular tachycardia (NSVT) detected on the Holter ( ≥6 beats, at \>120 BPM ) plus arrhythmias detected by the ICD

Frequency of arrhythmias between baseline and 3-months3-months

Total arrhythmia frequencies between baseline and 3-months will be the sum of non-sustained ventricular tachycardia (NSVT) detected on the Holter ( ≥6 beats, at \>120 beats per minute \[BPM\] ) plus arrhythmias detected by the ICD

Secondary Outcome Measures
NameTimeMethod
Frequency of ICD therapies between baseline and 3-months3-months

Obtained from ICD interrogation reports from recording between baseline and 3-months

Change in High Frequency heart rate variability (HF-HRV) between baseline and 3-months3-months

Index of parasympathetic activity; obtained from 24-hour Holter recording

Frequency of ICD therapies between 3-months and 9-months9-months

Obtained from ICD interrogation reports between 3- and 9-months

Change in High Frequency heart rate variability (HF-HRV) between 3- and 9-months9-months

Index of parasympathetic activity; obtained from 24-hour Holter recording

Trial Locations

Locations (1)

Medical University of South Carolina, Dept of Psychiatry, Division of Bio-Behavioral Medicine

🇺🇸

Charleston, South Carolina, United States

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