The fear that a cardiac arrest or life-threatening arrhythmia will happen again. Fear of recurrence is one of the most commonly reported psychological difficulties among cardiac arrest survivors and ICD patients, and can significantly affect quality of life, physical activity, return to work, and relationships. It may present as avoidance of exercise, reluctance to be alone, hypervigilance about physical symptoms, or anxiety about ICD shocks. For some people, the presence of an ICD — while protective — paradoxically amplifies fear of recurrence rather than reducing it. Psychological support, including CBT and peer support, can help people develop a more balanced relationship with risk and uncertainty. Fear of recurrence in co-survivors is equally common and often overlooked.
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