The Importance of Selecting Permanent Pacemaker, Evaluating the Heart and Assessing Quality of Life in Cardiac Patient.

The use of pacemakers is necessary for patients with symptomatic bradycardia. Pacemaker implantation also acts as a life-saving procedure. However, there are several reports that patients with a pacemaker (the most widely used pacemaker is on the right ventricle, known as single chamber pacemaker) had disturbances in left ventricle contraction lead to left ventricular systolic dysfunction. Global Longitudinal Strain (GLS) Echocardiography can confirm these left ventricular disturbances. Echocardiography examination is best carried out before and after single-chamber PPM implantation. This study compares PPM placement in apical Right Ventricle (RV) and Right Ventricular Outflow Tract (RVOT) and compares paced QRS duration 150 ms and > 150 ms. Pacing burden >40% causes subclinical left ventricular systolic dysfunction after a month of PPM implantation with decreased GLS in apical RV pacing.This study gives additional information that PPM placement is preferably in RVOT with some specific settings. However, there are many ways to reduce the effects of impaired left ventricular function due to lead installation on the PPM single-chamber device. By using the PPM device which has a dual chamber, the leads will be placed in RVOT and also in the right atrium with atrial-ventricle synchronization. The aim is to avoid impaired left ventricular pump function as supported by a systematic review which states the superiority of dual-chamber PPM over single-chamber PPM in reducing atrial fibrillation and pacemaker syndrome. In the importance of quality of life related to heart disease, the Indonesian version of the MacNew questionnaire can be used. This questionnaire seeks the quality of life of patients with coronary heart disease after revascularization surgery and has undergone rehabilitation. Another important thing is the suitability of the adaptation to the original English version.

Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires.

Background Cardiovascular disease (CVD) is responsible for 18 million annual deaths worldwide. CVD affects patients' Quality of Life (QoL) mainly in physical, emotional and social dimension. Aim To assess the QoL of patients with CVD in Northern Greece, using three different instruments. Methods The study was conducted in one large hospital located in a major Greek city. A convenience sample of 80 patients participated. A questionnaire including Short Form-36 Health Survey (SF-36), EuroQoL 5-dimensions 5-levels (EQ-5D-5L), MacNew, demographic, and clinical characteristics was used to collect data. Results The mean age of the patients was 63.31±14.07. Analysis revealed statistically significant main effects of age on the physical limitations, emotional limitations, social functioning, and pain. Also, the analysis showed significant main effects of education on the MacNew Physical, MacNew Social, and the EQ-5D-5L index (p< 0.05). Participants who had graduated primary school had significantly lower quality of life scores than higher education graduates in the MacNew physical (p< 0.02). Furthermore, in the SF-36 pain subscale, the heart failure group had a significantly lower quality of life than the other heart diseases (p= 0.03). Conclusion Quality of life is affected by factors such as age, type of heart disease, therapy, and comorbidities. Health care providers should be knowledgeable of the factors that affect the quality of life sectors (physical, emotional, and social life) of patients with CVD in order to meet their needs and have the most suitable treatment.

Validation of the French version of the MacNew heart disease health-related quality of life questionnaire.

BACKGROUND: Assessment of health-related quality of life is widely recommended by European health agencies in relevant research studies as well as in clinical care. AIMS: To validate the French version of the MacNew heart disease health-related quality of life questionnaire. METHODS: As part of the International HeartQoL Project, 323 French-speaking patients with ischaemic heart disease (angina, n=76; myocardial infarction [MI], n=155; heart failure, n=91; mean age 58.6±11.3 years) were recruited at seven cardiac rehabilitation centres. All patients completed the French versions of the MacNew questionnaire, the Short Form-36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale, to evaluate the psychometric properties of the French version of the MacNew instrument. RESULTS: The mean MacNew global scale scores were 4.6±0.8, 5.0±1.0 and 4.8±0.9 in patients with angina, MI and heart failure, respectively (P<0.05, MI versus angina). We observed minimal missing items and ceiling effects and no floor effects. Factor analysis confirmed a three factorial structure explaining 55.9% of the observed variance. Internal consistency reliability (Cronbach's α) ranged from 0.86 to 0.94 and test-retest reliability ranged from 0.68 to 0.73 Convergent validity was confirmed in the total group and each diagnosis, although the correlations between the MacNew physical subscale and the SF-36 mental component summary were higher than expected. Discriminative validity was partially confirmed with the SF-36 health transition item and fully confirmed with anxiety and depression as predictor variables. CONCLUSION: The French version of MacNew questionnaire is recommended for assessing health-related quality of life in French-speaking patients with ischaemic heart disease.

Cognitive-behavioral therapy and quality of life: An experience among cardiac patients.

BACKGROUND: Considering the significance of quality of life in chronic diseases and the role of education in its improvement, this study was performed to investigate the effect of cognitive-behavioral therapy on improving the quality of life of cardiovascular patients in Isfahan city. MATERIALS AND METHODS: In this experimental study, 56 patients, who referred to Chamran Hospital and Isfahan Cardiovascular Research Center, were randomly selected and assigned to two groups, i.e. experiment and control. The experiment group was trained in eight sessions, each session taking 2 hours. Both groups received MacNew quality of life questionnaire before and 2 weeks after treatment. Some demographic data were also gathered along with the questionnaire. Data were analyzed by SPSS software using statistical tests such as independent t-test, Chi-square, and analysis of covariance. RESULTS: Observing the possible effect of pre-test, cognitive-behavioral therapy had a significant effect on the total score of quality of life and its three subscales. CONCLUSION: It seems that along with other medical therapies, making use of cognitive-behavioral intervention is an appropriate method for improving the quality of life of cardiovascular patients.