York researchers help patients cope with pacemaker shock

Heart patients with pacemakers implanted in their chests experience psychological stress every time the devices do what they’re designed to do: electrically shock the heart to restore its proper rhythm.

Jazne Irvine“The effect of these shocks is similar to the impact of a gunshot to the chest,” explains Jane Irvine, a professor in York’s Department of Psychology, Faculty of Arts, who is researching the problem. “Many of the patients who have experienced multiple shocks begin to develop symptoms of post-traumatic stress disorder,” she says.

Right: Jane Irvine

Irvine’s team is mid-way through a four-year study funded by the Heart and Stroke Foundation of Ontario. Irvine’s goal is to create a routine maintenance program for patients with implants. Her team has already written a manual, based on a thesis by graduate student Jill Stanley, to help patients cope with the stress of possible shocks and has helped set up additional support through phone counselling. Irvine’s team also promotes education about the implants and teaches meditation and relaxation, both of which can help patients cope with the effects of the shocks.

Apart from the very real physical effects of the implants, some effects are psychological. “A number of patients also begin to create superstitious associations in their heads in the aftermath of a shock,” Irvine says. “For example, if someone receives a shock while turning on the radio, they think that, if they don’t turn on the radio anymore, they won’t have another heart rhythm problem and thereby be able to avoid ICD [implantable cardioverter-defibrillators] shocks.”

Although the federal government currently limits the number of defibrillator implants performed each year to patients with known life-threatening rhythm problems, there is a move in the US to also use the devices as part of a preventative strategy. Recent guidelines have suggested that about 90,000 Canadians should be fitted with the $25,000 defibrillators, although heart specialists acknowledge it’s a costly way to save lives. Until now, the devices have been used only in people who have survived a cardiac arrest, which is about 3,000 each year. Medical experts contend that the devices could save up to one quarter of the deaths in individuals with a weakened heart pump.

Irvine, who did her undergraduate work at York (BA Hons., ’74) before completing a master’s degree at the University of Edinburgh and her PhD at Oxford, specializes in health psychology. In addition to teaching at York and the University of Toronto, she is a research scientist in the Behavioural and Health Sciences Division at Toronto General Hospital, University Health Network, and associate psychologist in the Department of Psychology at Toronto’s Hospital for Sick Children.