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Positive Therapy for Autonomic Function & Mood in ICD Patients (PAM-ICD)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT02088619
First Posted: March 17, 2014
Last Update Posted: October 2, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Medical University of South Carolina
  Purpose
The purpose of this 2-group randomized clinical trial is to: 1) examine the feasibility and acceptability of a 3-month positive-emotion focused therapy (Quality of Life Therapy) modified specifically for patients with implantable cardioverter defibrillator (ICD); and 2) obtain estimates of effect size for QOLT compared to Heart Healthy Education on the changes in arrhythmia frequency and biomarkers of autonomic function, as well as changes in emotion, mood, and well-being across time (baseline, 3 & 9-months). It is hypothesized that the QOLT will promote improvements in autonomic function, reduced arrhythmia frequency, and improved psychological well-being.

Condition Intervention
Ventricular Arrhythmia Implantable Cardioverter Defibrillator Behavioral: Quality of Life Therapy (QOLT) Behavioral: Heart Healthy Education (HHE)

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Positive Psychotherapy to Improve Autonomic Function and Mood in ICD Patients

Further study details as provided by Medical University of South Carolina:

Primary Outcome Measures:
  • Frequency of arrhythmias between baseline and 3-months [ Time Frame: 3-months ]
    Total arrhythmia frequencies between baseline and 3-months will be the sum of non-sustained ventricular tachycardia (NSVT) detected on the Holter ( ≥6 beats, at >120 beats per minute [BPM] ) plus arrhythmias detected by the ICD

  • Frequency of arrhythmias between 3-months and 9-months [ Time Frame: 9-months ]
    Total arrhythmia frequencies between 3-months and 9-months will be the sum of non-sustained ventricular tachycardia (NSVT) detected on the Holter ( ≥6 beats, at >120 BPM ) plus arrhythmias detected by the ICD


Secondary Outcome Measures:
  • Frequency of ICD therapies between baseline and 3-months [ Time Frame: 3-months ]
    Obtained from ICD interrogation reports from recording between baseline and 3-months

  • Change in High Frequency heart rate variability (HF-HRV) between baseline and 3-months [ Time Frame: 3-months ]
    Index of parasympathetic activity; obtained from 24-hour Holter recording

  • Frequency of ICD therapies between 3-months and 9-months [ Time Frame: 9-months ]
    Obtained from ICD interrogation reports between 3- and 9-months

  • Change in High Frequency heart rate variability (HF-HRV) between 3- and 9-months [ Time Frame: 9-months ]
    Index of parasympathetic activity; obtained from 24-hour Holter recording


Other Outcome Measures:
  • Florida Shock Anxiety Scale [ Time Frame: 3 months ]
  • Florida Patient Acceptance Scale [ Time Frame: 3-months ]
  • Emotions Questionnaire [ Time Frame: 3-months ]
  • Center for Epidemiologic Studies - Depression Scale (CES-D) [ Time Frame: 3-months ]
  • State Trait Anxiety Inventory (STAI) [ Time Frame: 3-months ]
  • Life Orientation Test - Revised (LOT-R) [ Time Frame: 3-months ]
  • Positive and Negative Affect Schedule (PANAS) [ Time Frame: 3-months ]
  • Satisfaction with Life Scale (SWLS) [ Time Frame: 3-months ]
  • Quality of Life Inventory (QOLI) [ Time Frame: 3-months ]
  • Short-Form Health Survey-36 (SF-36) [ Time Frame: 3-months ]
  • Minnesota Living with Heart Failure Questionnaire (MLHFQ) [ Time Frame: 3-months ]

Enrollment: 29
Actual Study Start Date: July 2014
Study Completion Date: January 2017
Primary Completion Date: January 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Quality of Life Therapy (QOLT)
Positive emotion-focused cognitive behavioral psychotherapy
Behavioral: Quality of Life Therapy (QOLT)
Active Comparator: Heart Healthy Education (HHE)
Heart healthy education program
Behavioral: Heart Healthy Education (HHE)

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Adult men and women (≥18 years of age) who have received an ICD for primary or secondary prevention of sudden cardiac death. All patients will have systolic left ventricular dysfunction due to coronary disease or nonischemic cardiomyopathy. There is no requirement for time since implant;
  2. Score ≥5 on the Hospital Anxiety and Depression Scale (HADS) anxiety or depression scales;
  3. Able to read and write English
  4. Able to commit to the 3-month QOLT/HHE program and 3 assessments over a 9-month duration.

Exclusion Criteria:

  1. >5% atrial or ventricular pacing;
  2. Sinus node dysfunction;
  3. Persistent and permanent atrial fibrillation (AF) (h/o of paroxysmal AF will be allowed).
  4. Long QT syndrome; and other channelopathies such as Brugada syndrome;
  5. Hypertrophic cardiomyopathy;
  6. Neurocognitive or cognitive impairments;
  7. Severe psychopathology that warrants intensive treatment;
  8. Participation in another research trial; and
  9. Currently in psychological or psychiatric treatment.
  10. Current psychotropic and cardiac medication prescriptions and usage need to be stable (i.e., no change in type or dosage) for 3-months prior to study enrollment.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02088619


Locations
United States, South Carolina
Medical University of South Carolina, Dept of Psychiatry, Division of Bio-Behavioral Medicine
Charleston, South Carolina, United States, 29425
Sponsors and Collaborators
Medical University of South Carolina
National Heart, Lung, and Blood Institute (NHLBI)
Investigators
Principal Investigator: Eva R Serber, PhD Medical University of South Carolina
  More Information

Publications:
Frisch M. Quality of Life Therapy; Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy. Hobokon, NJ: John Wiley & Sons, Inc.; 2006.

Responsible Party: Medical University of South Carolina
ClinicalTrials.gov Identifier: NCT02088619     History of Changes
Other Study ID Numbers: Pro00028869
1R34HL107733-01A1 ( U.S. NIH Grant/Contract )
First Submitted: February 18, 2014
First Posted: March 17, 2014
Last Update Posted: October 2, 2017
Last Verified: September 2017

Keywords provided by Medical University of South Carolina:
psychological wellbeing
anxiety
depression
autonomic functioning