Sexual dysfunction, depression and quality of life in male implantable cardioverter defibrillator (ICD) recipients - With and without shock delivery

Background and objectives: Sexual concerns are prevalent among ICD recipients. Our goal was to evaluate the prevalence of sexual dysfunction (SD), depression, and quality of life (QOL) in male recipients of ICD with and without shock delivery. Patients and methods: ICD implanted males were asked to fill-out 3 self-administered questionnaires: Florida Patient Acceptance Survey (FPAS), Centre for Epidemiologic Studies Depression Scale (CES-D), and Arizona Sexual Experiences Scale (ASES). All patients were offered a referral to a sex clinic. Results: A total of 47/72 patients (65%), agreed to participate. Patients were classified into no-shock [NS] (66%) and at least one shock [S] (34%) groups. SD defined as worse than median ASES male score was found in 42.6% of the patients, 52% and 25% in NS/S groups, respectively (p=0.08). ICD related deterioration in sexual function (SF) was reported by 71% vs. 44% of NS/S groups, respectively (p=0.069), and by 85% of the patients with SD vs. 44.4% of the better SF group (p=0.005). Twenty three (49%) patients were referred to a sex clinic. Depression (CES-D score=16) was found in 36% of the study group. CES-D score mean ranks were 21 vs. 30 in the NS/S groups respectively, (p=0.049). QOL was similar in NS/S groups. No correlation was found between SD and depression or QOL, however, depression correlates with low QOL (Pearson correlation=0.416, p=0.04(. Conclusions: ICD implantation seems to impair male SF. Receiving a shock might be associated with a protective effect on SF. ICD implanted males are at risk for depression S>NS. QOL was similar in NS/S groups. ICD implanted males should be screened and treated for SD and depression.