Sexual concerns and practices after ICD implantation: findings of the COPE-ICD rehabilitation trial

Eur J Cardiovasc Nurs. 2013 Oct;12(5):468-74. doi: 10.1177/1474515112473528. Epub 2013 Jan 8.

Abstract

Background: Studies show that patients with implantable cardioverter defibrillators (ICD) frequently experience sexual dysfunction. These experiences are often linked to exercise intolerance, side-effects of medication, and psychological problems.

Objective: To describe (a) the level of information given about sexual activity, (b) the areas of patient concerns related to sexual function and the ICD, and (c) changes in sexual behavior.

Methods: A randomized controlled trial including 196 patients (1:1) was designed, including 12 weeks of exercise training and 1 year of psycho-educational follow-up focusing on modifiable factors associated with poor outcomes, including sexual functioning. The Sex After ICD Survey was administered 6 months after the randomization as part of the planned explorative outcomes. 141 patients responded.

Results: The analyses showed that 37 of the 69 (55.2%) patients of the intervention group and 16 of the 72 (24.6%) patients of the control group received information (p<0.001). The areas of greatest concern reported by many patients were: lack of interest in sex, erectile dysfunction, and an over-protective partner. Fewer patients were sexually active 6 months after the ICD implantation than before the ICD implant: 51.8% versus 66.7%. In the intervention group, patients had sexual intercourse a mean of 4.9 times during the previous 2 months versus 4.0 in the control group (p=0.4).

Conclusion: Despite having received more information, no interventional effect was found between groups in terms of sexual concerns or activity.

Keywords: ICD; comprehensive cardiac rehabilitation; sexual dysfunction.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arrhythmias, Cardiac / nursing
  • Arrhythmias, Cardiac / psychology*
  • Arrhythmias, Cardiac / rehabilitation*
  • Cardiovascular Nursing / methods*
  • Defibrillators, Implantable / psychology*
  • Exercise
  • Exercise Tolerance
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic / methods
  • Rehabilitation Nursing / methods
  • Sexual Dysfunctions, Psychological / nursing
  • Sexual Dysfunctions, Psychological / psychology*
  • Sexuality / psychology*