Although implanted cardioverter-defibrillators (ICDs) clearly reduce mortality, their effects on patients' psychological status is equivocal, with a substantial number of patients becoming depressed or anxious after ICD implantation. Significant numbers of ICD recipients, including those with heart failure (HF), remain anxious and depressed 1 year after ICD implantation. ICD recipients who are younger, female, and received ICD shocks are especially vulnerable to psychological distress. Screening for anxiety and depression is appropriate for all ICD recipients. Cognitive behavioral therapy and psychoeducational programs show promise for reducing psychological distress in ICD recipients with HF.
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