{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:57:44Z","timestamp":1792601864270,"version":"4.5.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Aim<\/jats:title>\n<jats:p>The association of cardiac implantable electronic devices (CIED), namely pacemaker (PM), implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy with (CRT-D) or without defibrillator (CRT-P) with health-related quality of life (HRQoL) is lacking.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and results<\/jats:title>\n<jats:p>Data from the Swedish Pacemaker and ICD Registry collected from January 2019 to February 2022 was used to analyze the responses to the European Quality of Life-5 Dimension questionnaire (EQ-5D) before and after one year of the CIED implant. Descriptive analysis was performed using Pearson\u2019s chi-square test, the analysis of variance ANOVA, the Kruskal-Wallis test and Wilcoxon signed-rank test when appropriate. A multivariable regression analysis was used to compare the EQ-5D index and EQ-VAS variation after 1 year. Of 1,479 who completed the EQ-5D, 80% had a PM, 10% an ICD, 5% a CRT-P and 6% a CRT-D. The median age was 77 years with females constituting 38% of the PM group and 17% of the ICD group. The EQ-VAS and the EQ-5D index significantly increased after one year from the PM and CRT-P implant (EQ-VAS +2.8, standard deviations (SD) 23 and +5.8, SD 24.9; EQ-5D index +0.019, SD 0.114 and +0.051, SD 0.125) while only the EQ-5D index increased after one year from the ICD implant (+0.002, SD 0.104). After adjusting for age, sex and HRQoL at baseline, the presence of defibrillator was associated with lower EQ-VAS (ICD EQ-VAS variation: -3.4, 95% confidence intervals (CI) -6.7; -0.1 and CRT-D EQ-VAS variation -4.8, 95% CI -8.8;-0.7) and EQ-5D index (ICD EQ-5D index variation: -0.018, 95% CI -0.035; -0.0003 and CRT-D EQ-5D index variation -0.025 95% CI 0.046;0.004) after one year compared to PM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>These findings, showing the HRQoL associated with CIED, are important to support physicians\u2019 and pacemaker nurses\u2019 care after device implantation by embracing the patients\u2019 perspectives.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0314978","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T18:31:42Z","timestamp":1734978702000},"page":"e0314978","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Health-related quality of life in a large cohort of patients with cardiac implantable electronic devices A registry-based 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Electrophysiol J Work Groups Card Pacing Arrhythm Card Cell Electrophysiol Eur Soc Cardiol"},{"issue":"3","key":"pone.0314978.ref005","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1016\/j.ijcard.2013.01.253","article-title":"Long term quality-of-life in patients with bradycardia pacemaker implantation","volume":"168","author":"EO Udo","year":"2013","journal-title":"Int J Cardiol"},{"issue":"4","key":"pone.0314978.ref006","first-page":"233","article-title":"The contribution of rate adaptive pacing with single or dual sensors to health-related quality of life","volume":"9","author":"NM van Hemel","year":"2007","journal-title":"Eur Eur Pacing Arrhythm Card Electrophysiol J Work Groups Card Pacing Arrhythm Card Cell Electrophysiol Eur Soc Cardiol"},{"issue":"10","key":"pone.0314978.ref007","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1056\/NEJMoa0706719","article-title":"Quality of life with defibrillator therapy or amiodarone in heart failure","volume":"359","author":"DB Mark","year":"2008","journal-title":"N Engl J Med"},{"issue":"3","key":"pone.0314978.ref008","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s10840-017-0233-y","article-title":"Longitudinal changes in quality of life following ICD implant and the impact of age, gender, and ICD shocks: observations from the INTRINSIC RV trial","volume":"48","author":"R Gopinathannair","year":"2017","journal-title":"J Interv Card Electrophysiol Int J Arrhythm Pacing"},{"issue":"3","key":"pone.0314978.ref009","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.hrtlng.2004.10.002","article-title":"Quality of life in implanted cardioverter defibrillator recipients: the impact of a device shock","volume":"34","author":"DL Carroll","year":"2005","journal-title":"Heart Lung J Crit Care"},{"issue":"6","key":"pone.0314978.ref010","first-page":"900","article-title":"The impact of implantable cardioverter-defibrillator implantation on health-related quality of life in the DANISH trial","volume":"21","author":"JS Bundgaard","year":"2019","journal-title":"EP Eur"},{"issue":"20","key":"pone.0314978.ref011","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1001\/jama.289.20.2685","article-title":"Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial","volume":"289","author":"JB Young","year":"2003","journal-title":"JAMA"},{"issue":"23","key":"pone.0314978.ref012","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1016\/j.jacc.2008.08.027","article-title":"Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms","volume":"52","author":"C Linde","year":"2008","journal-title":"J Am Coll Cardiol"},{"issue":"40","key":"pone.0314978.ref013","doi-asserted-by":"crossref","first-page":"4259","DOI":"10.1093\/eurheartj\/ehad591","article-title":"Upgrade of right ventricular pacing to cardiac resynchronization therapy in heart failure: a randomized trial","volume":"44","author":"B Merkely","year":"2023","journal-title":"Eur Heart J"},{"issue":"11","key":"pone.0314978.ref014","doi-asserted-by":"crossref","first-page":"4769","DOI":"10.19102\/icrm.2021.121103","article-title":"Patient Perceptions and Quality of Life in Pacemaker Recipients","volume":"12","author":"M. Polikandrioti","year":"2021","journal-title":"J Innov Card Rhythm Manag"},{"issue":"22","key":"pone.0314978.ref015","doi-asserted-by":"crossref","first-page":"15368","DOI":"10.3390\/ijerph192215368","article-title":"Benefits of Participation in Clinical Trials: An Umbrella Review","volume":"19","author":"A Bouzalmate-Hajjaj","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"pone.0314978.ref016","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/JCN.0000000000000565","article-title":"\u2018Why Would I Choose Death?\u2019: A Qualitative Study of Patient Understanding of the Role and Limitations of Cardiac Devices","volume":"34","author":"RA Hadler","year":"2019","journal-title":"J Cardiovasc Nurs"},{"issue":"1","key":"pone.0314978.ref017","doi-asserted-by":"crossref","first-page":"37","DOI":"10.5935\/1678-9741.20140009","article-title":"Evaluation of patients\u2019 quality of life aspects after cardiac pacemaker implantation","volume":"29","author":"RT de Barros","year":"2014","journal-title":"Rev Bras Cir Cardiovasc Orgao Of Soc Bras Cir Cardiovasc"},{"issue":"5","key":"pone.0314978.ref018","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3109\/07853890109002087","article-title":"EQ-5D: a measure of health status from the EuroQol Group","volume":"33","author":"R Rabin","year":"2001","journal-title":"Ann Med"},{"issue":"1","key":"pone.0314978.ref019","first-page":"71","article-title":"2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"24","author":"M Glikson","year":"2022","journal-title":"Eur Eur Pacing Arrhythm Card Electrophysiol J Work Groups Card Pacing Arrhythm Card Cell Electrophysiol Eur Soc Cardiol"},{"issue":"7","key":"pone.0314978.ref020","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1016\/j.jacc.2018.10.044","article-title":"2018 ACC\/AHA\/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay","volume":"74","author":"FM Kusumoto","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"pone.0314978.ref021","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1067\/mjh.2002.124049","article-title":"Quality of life in the Canadian Implantable Defibrillator Study (CIDS)","volume":"144","author":"J Irvine","year":"2002","journal-title":"Am Heart J"},{"issue":"21","key":"pone.0314978.ref022","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1056\/NEJMoa032423","article-title":"Cardiac-Resynchronization Therapy with or without an Implantable Defibrillator in Advanced Chronic Heart Failure","volume":"350","author":"MR Bristow","year":"2004","journal-title":"N Engl J Med"},{"issue":"15","key":"pone.0314978.ref023","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"The effect of cardiac resynchronization on morbidity and mortality in heart failure","volume":"352","author":"JGF Cleland","year":"2005","journal-title":"N Engl J Med"},{"issue":"16","key":"pone.0314978.ref024","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1056\/NEJM199804163381602","article-title":"Quality of life and clinical outcomes in elderly patients treated with ventricular pacing as compared with dual-chamber pacing. Pacemaker Selection in the Elderly Investigators","volume":"338","author":"GA Lamas","year":"1998","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0314978.ref025","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/1403494811435493","article-title":"Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006","volume":"40","author":"S Sun","year":"2012","journal-title":"Scand J Public Health"},{"issue":"5","key":"pone.0314978.ref026","doi-asserted-by":"crossref","first-page":"639","DOI":"10.21470\/1678-9741-2020-0522","article-title":"Health-Related Quality of Life in Elderly Patients with Pacemakers","volume":"36","author":"NA In\u00e1cio","year":"2021","journal-title":"Braz J Cardiovasc Surg"},{"issue":"8","key":"pone.0314978.ref027","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1007\/s11136-005-4347-9","article-title":"Psychometric Properties of an Established Heart Disease Specific Health-related Quality of Life Questionnaire for Pacemaker Patients","volume":"14","author":"S H\u00f6fer","year":"2005","journal-title":"Qual Life Res"},{"issue":"3\u20134","key":"pone.0314978.ref028","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/jocn.13897","article-title":"Influence of frailty on the quality of life patients qualified for pacemaker implantation","volume":"27","author":"A Mlynarska","year":"2018","journal-title":"J Clin Nurs"},{"issue":"1","key":"pone.0314978.ref029","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/jce.14322","article-title":"Quality of life of patients undergoing conventional vs leadless pacemaker implantation: A multicenter observational study","volume":"31","author":"P Cabanas-Grand\u00edo","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"issue":"8","key":"pone.0314978.ref030","first-page":"257","article-title":"The Impact of Cardiac Devices on Patients\u2019 Quality of Life-A Systematic Review and Meta-Analysis","volume":"9","author":"K Willy","year":"2022","journal-title":"J Cardiovasc Dev Dis"},{"issue":"5","key":"pone.0314978.ref031","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1136\/heart.87.5.488","article-title":"QUALITY OF LIFE AND PSYCHOLOGICAL FUNCTIONING OF ICD PATIENTS","volume":"87","author":"SF Sears","year":"2002","journal-title":"Heart"},{"issue":"5","key":"pone.0314978.ref032","first-page":"860","article-title":"Long-term quality of life and acceptance of implantable cardioverter-defibrillator therapy: results of the European Heart Rhythm Association survey","volume":"24","author":"\u0141 Januszkiewicz","year":"2022","journal-title":"EP Eur"},{"issue":"7","key":"pone.0314978.ref033","doi-asserted-by":"crossref","first-page":"e047053","DOI":"10.1136\/bmjopen-2020-047053","article-title":"Health-related quality of life in patients with implantable cardioverter defibrillators in Sweden: a cross-sectional observational trial","volume":"11","author":"P Magnusson","year":"2021","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0314978.ref034","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.joa.2015.10.002","article-title":"Influence of primary and secondary prevention indications on anxiety about the implantable cardioverter-defibrillator","volume":"32","author":"A Rahmawati","year":"2016","journal-title":"J Arrhythmia"},{"issue":"9","key":"pone.0314978.ref035","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1007\/s40520-018-1088-5","article-title":"influence of age on the psychological profile of patients with cardiac implantable electronic devices: results from the Italian population in a multicenter study conducted by the European Heart Rhythm Association","volume":"31","author":"S Fumagalli","year":"2019","journal-title":"TheAging Clin Exp Res"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0314978","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T18:31:54Z","timestamp":1734978714000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0314978"}},"subtitle":[],"editor":[{"given":"Marcelo Arruda","family":"Nakazone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,23]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0314978","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,23]]}}}