People who are implanted with cardioverter defibrillators should be carefully monitored and screened for depression, anxiety and post-traumatic stress disorder, according to officials with the American Heart Association.

ICDs are used in people with heart failure or other underlying heart conditions.

“A shock from an ICD can be lifesaving, but it can also affect a person’s quality of life and psychological state,” Sandra B. Dunbar, R.N., D.S.N, said in an AHA statement.

Education and support services should go beyond just focusing on device maintenance, according to the association. Doctors and nurses should address ICD-specific concerns about symptoms, heart disease treatment, physical activities and end-of-life issues, as well. 

“Experiencing a shock is distressing and patients have a wide variety of responses,” Dunbar added. “We suggest that clinicians provide an ongoing assessment of ICD patients’ psychological needs.”

Providers should counsel that while an ICD protects against sudden death, it does not improve underlying heart conditions.

The AHA’s statement was published in September in the journal Circulation