Exploring the experiences of individuals with an insertable cardiac monitor: Making the decision for device insertion

Abstract

Background: Little is known about the decision-making process for insertable cardiac monitors (ICM) in those with suspected arrhythmias.

Objective: The purpose of this qualitative study was to describe how individuals make a decision to insert an ICM.

Methods: A qualitative descriptive design was used. Data were analyzed using content analysis and constant comparison. NVivo 10 was used for data grouping and patterns.

Results: Participants (N = 12) ranged in age from 41to 95. Most (n = 7) had the device inserted because of syncope or atrial fibrillation (AF), and others (n = 5) for cryptogenic stroke. Three categories emerged: pre-decision, definitive decision, and deliberated decision. Event symptoms, including physical, cognitive and emotional, and trust emerged as factors in decision-making.

Conclusions: Those who perceived their experience as life-threatening, trusted the healthcare provider and assented to the ICM insertion. Conversely, those who perceived symptoms as episodic, used other strategies to resolve symptoms prior to making the decision for insertion.

Keywords: Atrial fibrillation; Cryptogenic stroke; Decision-making; Insertable cardiac monitor.