Assessment of shoulder pain and shoulder disability in patients with implantable cardioverter-defibrillator.

Purpose: Shoulder pain and disability is a common but overlooked disorder in patients with implantable cardioverter-defibrillators (ICD). We aimed to assess chronic shoulder pain and disability in patients with ICD.
Methods: Two hundred fifty-four patients (mean age, 66 ± 12 years; 156 men) with ICD were included in the study. The Shoulder Pain and Disability Index (SPADI) was used for assessment of shoulder pain and disability.
Results: Of the patients, 131 (52 %) have shoulder pain and disability. The total mean SPADI score in patients with shoulder pain and disability was 33 ± 18 and was significantly higher than in patients without shoulder pain and disability (11 ± 2; p < 0.001). Patients with three-lead ICD have significantly higher SPADI scores than patients with single-lead ICD (p < 0.001). Number of leads correlated with pain score (p = 0.001, r = 0.253), disability score (p = 0.006, r = 0.174) and total SPADI score (p = 0.001, r = 0.213). In multivariate analysis, significant associates of shoulder pain and disability were evaluated, adjusting for age, sex, body mass index, procedure time, implantation time interval, limitation of shoulder activity and number of leads. Number of leads was the only predictor of shoulder pain and disability (OR 0.518, 95 % CI, 0.372-0.721; p < 0.001).
Conclusions: Patients with ICD implantation frequently have chronic shoulder pain and disability. Patients with three leads suffer more shoulder pain and disability.