Evaluation of shoulder function and quality of life in patients with cardiac implantable electronic devices

Tóm tắt

Objective: Assessment of Shoulder Joint Function and Quality of Life in Patients with Cardiac Implantable Electronic Devices. Background: Some common complications after cardiac implantable electronic device implantation include shoulder pain, reduced range of motion, impaired shoulder function, and decreased quality of life after device placement, which may persist thereafter. Methods: A retrospective cohort study at a hospital in Southern Vietnam from February 2023 to February 2025. Results: The study included 116 patients who underwent cardiac implantable electronic device implantation. Women accounted for 45.7%, and the mean age was 64.5 ± 14.5 years. Common comorbidities were hypertension (52.6%), diabetes mellitus (53.4%), dyslipidemia (48.3%), and chronic coronary artery disease (42.2%). The implanted devices were predominantly dual-chamber pacemakers (49.1%) and single-chamber pacemakers (40.5%), followed by ICDs (7.8%) and CRT devices (2.6%). The most frequent indications were sick sinus syndrome (44.0%) and atrioventricular block (45.7%). Shoulder pain (VAS) increased markedly immediately after implantation (0.14 ± 0.09 pre-implantation to 7.85 ± 1.06 post-implantation), then gradually decreased at 1 month (4.53 ± 0.92) and 3 months (1.55 ± 0.93), remaining significantly different from baseline at all time points (p < 0.001). Upper-limb function assessed by QuickDASH deteriorated sharply immediately after implantation (1.31 ± 1.13 pre-implantation to 79.53 ± 6.90 post-implantation), with progressive improvement at 1 month (33.33 ± 7.49) and 3 months (11.97 ± 6.99) (p < 0.001 vs baseline). Health-related quality of life (SF-36) improved after implantation and continued to increase over time: 46.01 ± 10.06 (pre-implantation), 58.54 ± 12.39 (post-implantation), 77.54 ± 12.04 (1 month), and 81.97 ± 7.92 (3 months) (p < 0.001). Conclusion: After cardiac implantable electronic device implantation, patients commonly experience shoulder pain and marked early upper-limb functional limitation, reflected by a sharp immediate increase in VAS and QuickDASH scores. These measures gradually improved over time, with substantial recovery by 3 months, while quality of life (SF-36) increased significantly. These findings suggest that shoulder symptoms should be routinely monitored and that early rehabilitation interventions may help reduce pain, restore mobility, and optimize quality of life after device implantation.