After the storm: How do partners of those receiving an implantable cardioverter defibrillator (ICD) experience episodes of electrical storm, which have resulted from ICD activation (shocks)? An exploration using Interpretative Phenomenological Analysis

Literature review: Atrial fibrillation (AF) has been associated with reduced psychosocial functioning, and such reductions may be influenced by illness perceptions. Although one published review has explored the relationships between illness perceptions and emotional wellbeing in AF patients, it had a narrow focus and lacked robust quality appraisal. Thus, the aims of the current review were to systematically review relationships between illness perceptions and broader psychosocial outcomes in AF patients, and to quality appraise the available literature. Thirteen studies were elicited. Although findings were equivocal, studies identified that particular illness perceptions were related to and, in some cases, appeared to predict poorer psychosocial functioning in terms of reduced emotional wellbeing, poorer quality of life (QOL) and health-related quality of life (HRQOL), adjustment, and treatment seeking delay. It is recommended that the illness perceptions of AF patients are assessed, and modified where indicated. Further research is warranted and suggestions are provided. Empirical Study: Implantable cardioverter defibrillators (ICDs) are potentially life-saving devices. However, ICD recipients and their partners may experience negative psychosocial consequences following implantation and any isolated device activations. Furthermore, ICDs may activate multiple times, with three or more activations within 24 hours being classed as an electrical storm (ES). Although ESs have been shown to cause psychological difficulties for ICD recipients, no studies have investigated the impact of ESs on partners. Semi-structured interviews were conducted with six participants who had witnessed their partner suffering an ES. The data were analysed using Interpretative Phenomenological Analysis (IPA) and four superordinate themes were identified: ‘Feeling overwhelmed during the ES (all at sea)’, ‘Challenges in post-ES adjustment’, ‘Trying to cope (not being becalmed)’, and ‘Living and growing’. There is a need for professionals to engage with partners and support them prior to, and following ESs. Further research is warranted and suggestions are provided.