Disturbance in bodily experience following ventricular assist device implantation

Fabian Richter; Hannah Spielmann; Sandra Semmig-Koenze; Christine Spitz-Köberich; Christoph Knosalla; Christiane Kugler; Katharina Tigges-Limmer; Wolfgang Albert

doi:10.1016/j.healun.2023.10.019

Disturbance in bodily experience following ventricular assist device implantation

J Heart Lung Transplant. 2023 Nov 3:S1053-2498(23)02109-5. doi: 10.1016/j.healun.2023.10.019. Online ahead of print.

Authors

Fabian Richter¹, Hannah Spielmann², Sandra Semmig-Koenze³, Christine Spitz-Köberich⁴, Christoph Knosalla⁵, Christiane Kugler², Katharina Tigges-Limmer⁶, Wolfgang Albert⁷

Affiliations

¹ Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
² University of Freiburg, Faculty of Medicine, Institute of Nursing Science, Freiburg, Germany.
³ Leipzig Heart Center, Leipzig, Germany.
⁴ Medical Center - University of Freiburg, University Heart Center Freiburg, Bad Krozingen, Germany.
⁵ Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.
⁶ Heart and Diabetes Center North-Rhine Westphalia, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany.
⁷ Deutsches Herzzentrum der Charité, Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany. Electronic address: wolfgang.albert@dhzc-charite.de.

PMID: 37923150
DOI: 10.1016/j.healun.2023.10.019

Abstract

Background: Disturbance in bodily experience (BE) is a potential adverse consequence of ventricular assist device (VAD) implantation. The concept BE encompasses all cognitive and affective processes related to the subjective experience of one's own body.

Methods: A cross-sectional, multicenter study was performed, involving 365 VAD patients (85% male; time postimplant: 3-36 months). Patients completed a BE questionnaire (BE-S, 5-point Likert scale), and the disturbance in BE was analyzed based on sex, time since implantation (in the first, second, or third years postimplant), and patient acuity (elective vs emergent implantation). Subsidiary, patients' gratitude was surveyed.

Results: Disturbance in BE was not particularly pronounced (mean = 2.69, standard deviation = 1.17). Eighty-five percent of patients expressed high levels of gratitude. Disturbance in BE decreased (p = 0.04), while gratitude increased (p = 0.02) with time since implantation. Female patients showed more disturbance in BE (p = 0.01) and less gratitude (p = 0.01) compared to male patients. Among patients who underwent emergency implantation, the decrease in disturbance occurred predominantly in the third year, exceeding the level observed in elective implanted patients (p = 0.03).

Conclusions: Disturbance in BE following VAD implantation does generally not reach excessive levels and tends to decrease over time. Our data indicate more disturbance and less gratitude in female patients. In emergently implanted patients, disturbance in BE is prolonged. Screening for disturbance in BE is recommended during follow-up, especially for these at-risk groups, to ensure early and focused psychological support.

Keywords: VAD; body image; disturbance in bodily experience; psychological device integration; ventricular assist device.