MONDAY, Nov. 14 (HealthDay News) -- For people with implantable
cardioverter defibrillators, the life-saving device may come at a
cost: Fear of it firing a shock to the heart during sex drives some
to avoid lovemaking altogether.
Implantable cardioverter defibrillators (ICD) are small devices
placed in the chest or abdomen that shoot off electrical pulses
when they detect potentially life-threatening, irregular
But shock-related anxiety can impede sexual performance,
according to new research scheduled for presentation Tuesday at the
American Heart Association annual meeting in Orlando, Fla.
These fears are warranted, said study author Dr. Steven Cook,
director of adult congenital heart disease at Children's Hospital
of Pittsburgh. "It's a huge deal that no one talks about sexual
function with these patients," Cook said.
ICDs can fire during sex or any other time that they sense a
dangerous arrhythmia, Cook added. And the jolt can be frightening.
He said that patients tell him the shock feels like "someone kicked
you in the chest. It is a pretty intense sensation."
The new study included 151 men and women who had congenital
heart disease, meaning a heart abnormality since birth. Of these,
41 had ICDs and an average age of 37. Those without an ICD averaged
32 years. Study participants rated their sexual function and
depression via standardized tools, which included questions about
confidence, satisfaction and arousal. Those individuals with ICDs
also completed the Florida Shock Anxiety Scale, which measures
fears about ICD-related shock.
Men with ICDs had sexual function scores similar to the ratings
of men with mild erectile dysfunction (the inability to achieve or
maintain an erection sufficient for sexual intercourse).
The sexual function scores of women with and without ICDs showed
little difference, suggesting men might be more affected by
Many people with congenital heart disease may be depressed,
which could affect their sexual function, but depression scores
were in the normal range for all of the study participants -- those
with and without ICDs, the study showed.
Men and women who reported high levels of shock-related anxiety
had lower sexual function scores compared with their counterparts
who were not anxious about their device firing. It didn't matter if
these individuals were single or in committed relationships. Some
may have experienced a shock in the past, while others might just
fear experiencing one in the future, Cook said.
Communication between patients and their doctors is critical to
allay any fears, Cook said. Anyone shocked in the past who dreads
another jolt should try to figure out why the device fired in the
first place, Cook said.
Solutions exist, based on whether the ICD fired appropriately or
inappropriately. Doctors can tweak your medication regimen to help
control the underlying heart problem or reprogram the device, he
In the future, it may help to have doctors screen people for
shock-related anxiety before implanting the device, he said.
This is a real issue, said Dr. Joshua M. Hare, the Louis Lemberg
Professor of Medicine at the University of Miami Miller School of
Medicine. "It is an interesting dilemma because the same device
that can save your life also has side effects," he said.
"It's the right treatment, but there is the risk that it could happen at the wrong time," he said. "If you don't have the device you are at risk for a potentially fatal event, but having the device can be anxiety-provoking and create psychosocial issues."
"You have to pick your poison," he said.
Research presented at meetings should be considered preliminary
until published in a peer-reviewed medical journal.
Find out more about implantable cardioverter devices at the
U.S. National Heart, Lung, and Blood
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