Decreased Quality of Life Due to Driving Restrictions after Cardioverter Defibrillator Implantation

Abstract

Background: Driving restrictions for patients with an implantable cardioverter defibrillator (ICD) may require significant lifestyle adjustment and affect patients' psychological well-being. This study explored the prevalence of, and factors associated with, patient-reported decrease in quality of life due to driving restrictions in the first 2 months postimplantation. Methods: Dutch ICD patients (N = 334; median age, 64 [interquartile range, 55-70) years; 81% male) completed questionnaires at the time of implantation and 4 months postimplantation, assessing their sociodemographic, psychological, and driving-related characteristics. Clinical baseline data were retrieved from patients' medical records. Results: Nearly half of the patients (49%) reported decreased quality of life due to driving restrictions. Patient-reported reasons included dependency on others/public transport, (social) isolation, and inability to work. Patients reporting decreased quality of life were more likely to be younger (P =.01), to feel that the restriction lasts too long (P =.004), to have considered ICD refusal because of the restrictions (P =.03), and to have Type D personality (P =.02), anxiety (P =.05), depression (P =.003), and ICD-related concerns (P =.02). Multivariable analysis showed that being younger than 60 years (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.09-4.88; P =.03), feeling the driving restriction lasts too long (OR, 1.77; 95% CI, 1.23-2.55; P =.002), and depression (OR, 3.21; 95% CI, 1.09-9.47; P =.035) were independently associated with decreased quality of life due to driving restrictions. Conclusions: This study indicated that a significant group of ICD patients may experience decreased quality of life because of the driving restrictions postimplantation. The restrictions seem to particularly affect patients who are younger and distressed and patients who feel that the restriction lasts too long.