Shock-related anxiety and sexual function in adults with congenital heart disease and implantable cardioverter-defibrillators

Stephen C. Cook*, Anne Marie Valente, Timothy M. Maul, Mary Amanda Dew, Jenne Hickey, Jennifer Burger, Amy Harmon, Mathieu Clair, Gregory Webster, Frank Cecchin, Paul Khairy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


BACKGROUND: An increasing number of adults with congenital heart disease (CHD) require implantable cardioverter-defibrillators (ICDs),yet little is known about their impact on psychological well-being and sexual function. OBJECTIVE: To assess shock-related anxiety in adults with CHD and its association with depression and sexual function. METHODS: A prospective, multicenter, cross-sectional study was conducted on adult patients with CHD with (ICD +) and without (ICD-) ICDs. The Florida Shock Anxiety Scale was administered to patients with ICD+ and the Beck Depression Inventory-II to all patients. Men completed the Sexual Health Inventory for Men, and women completed the Female Sexual Function Index. RESULTS: A total of 180 adults with CHD (ICD+: n = 70; ICD-: n = 110; median age 32 years [interquartile range 27-40 years]; 44% women) were enrolled. The complexity of CHD was classified as mild in 32 (18%), moderate in 93 (52%), and severe in 54 (30%) subjects. In ICD recipients, a high level of shock-related anxiety was identified (Florida Shock Anxiety Scale score 16; interquartile range 12-23.5), which was slightly higher than the median score for ICD recipients in the general population (P = .057). A higher level of shock-related anxiety was associated with poorer sexual function scores in both men (Spearman's ρ = -.480; P < .001) and women (Spearman's ρ = -.512; P < .01). It was also associated with self-reported depressive symptomatology (Spearman's ρ = .536; P < .001). CONCLUSIONS: Adults with CHD and ICDs demonstrate a high level of shock-related anxiety, which is associated with lower sexual functioning scores in men and women. These results underscore the need for increased clinical attention related to ICD-related shock anxiety and impaired sexual function in this population.

Original languageEnglish (US)
Pages (from-to)805-810
Number of pages6
JournalHeart rhythm
Issue number6
StatePublished - Jun 2013


  • Anxiety
  • Congenital heart disease
  • Depression
  • Implantable cardioverter-defibrillator
  • Sexual function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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