In the United States sudden cardiac death claims approximately 400,000 lives annually; 80% of those who experience a sudden cardiac death episode die before they can be resuscitated. Of those who survive, an estimated 20% cannot be helped by surgery or conventional anti-arrythmic therapy (Moser, Crawford, & Thomas, 1988). The automatic implantable cardioverter defibrillator (AICD), approved by the Food and Drug Administration in 1985 (Cooper, Valladares, & Futterman, 1987), protects patients at high risk for recurring sudden cardiac death. The AICD, surgically implanted in the abdomen, continuously monitors the individual's heart rhythm and, when necessary, delivers an electrical shock directly to the myocardium.

Understandably, this population will experience anxiety as they attempt to cope with this life-saving device for their life-threatening disease. Authors have documented that stress and anxiety may have adverse effects on the myocardium increasing the possibility of arrythmias (Lown, 1987; Podrid, 1984) which frequently are the precursors of sudden cardiac death, and that relaxation states or regular meditation may decrease arrythmias (Benson, Alexander, & Feldman, 1975; Lown, 1987).

This study evaluated the use of audiotaped guided imagery relaxation exercises, entitled Daydreams (Whole Person Press, Inc., 1986), in male patients who had received an AICD, and were returning to the Cardiology Group of Memphis, P.A. for their regular monthly checkup. Thirty-one individuals agreed to participate and were randomly assigned to one of two groups: relaxation training (n = 13) or control (n = 18). Of the 31 in the initial sample, 25 completed the study (relaxation training = 13, control = 12).

Using the State-Trait Anxiety Inventory as a measure of anxiety, relaxation training was shown, via a one between groups-one within subjects analysis of variance, to have significant effects in lowering state anxiety levels in male AICD recipients (p = 0.003, 0.007, and 0.014). No such effects were found for trait anxiety levels (p = 0.302, 0.003, 0.263).

It was concluded that guided imagery relaxation training is a tenable, therapeutic intervention for reducing state anxiety levels in AICD recipients.