The Effect of Permanent Artificial Pacemakers on Patients' Health Related Quality of Life

Introduction: Permanent pacemaker implantation aim not only at extending, but also at reaching a better quality of life for patients they need them. Objective: To evaluate aspects of patients’ quality of life after pacemaker implantation. Material-Method: Descriptive correlational study of a convenience sample of patients enrolled during their follow-up visit at the Pacemaker Implantation Unit of a public hospital. The instruments employed were a) a questionnaire included patients’ demographic, clinical characteristics and functional NYHA class, b) SF-12 Health Survey (Greek version), c) the AQUAREL quality-of-life questionnaire (version 1.0). Statistical analysis was conducted using non parametric methods at a 5% significance level. Results: The sample consisted of 100 patients of both genders (66% men), with mean age of (mean±sd) 75.66±8.36 years and mean implantation time span (mean±sd) 3.4±4.26 years. Low scores of quality of life referred to both SF-12 components , with the lowest one in Mental Health (mean±sd) 45.56±11.1. The highest AQUAREL score referred to Chest Discomfort factor (mean±sd) 76.06± 19.2, whereas the lowest AQUAREL score referred to Dyspnea in Exertion factor (mean±sd) 65.32+20.5. There was a statistically significant correlation (p≤0.05) between: (a) gender with quality of life (SF-12) and chest discomfort (AQUAREL), (b) occupational status with arrhythmias-related quality of life (AQUAREL), (c) implantation time span with arrhythmia-related and cognitive dysfunction-related quality of life (AQUAREL). Strong correlations were observed between Greek version of AQUAREL questionnaire and NYHA classes, as well as generic SF-12. Conclusions: Patients with permanent pacemakers report low quality of life related to physical and mental health, though they were not impaired significantly under the effect of the factors of AQUAREL. Women presented lower health-related quality of life than men, especially due to chest discomfort and arrhythmias. The employed patients and those with longer pacemaker implantation time span reported better quality of life. NYHA and SF-12 work well with the Greek version of AQUAREL, which our results suggest that it is reliable, thus it could be used to assess quality of life in groups of permanent pacemaker patients.