mri under specified safe operating conditions. quality of life implantable cardioverter defibrillators have demonstrated clear life-saving benefits, while concerns about patient acceptance and psychological adjustment to the icd have been the focus of much research. researchers, including those from the field of cardiac psychology, have concluded that the quality of life (qol) of icd patients is at least equal to, or better than, that of those taking anti-arrhythmic medications. the largest study of examined 2,521 patients with stable heart failure in the scd-heft trial. results indicated that there were no differences between icd-treated and medication-treated groups at 30 months in patient-reported qol. psychological adjustment following icd implantation has also been well studied. in rare cases, the icd can become infected and is usually bacterial in origin but other organisms such as certain fungi have occasionally been implicated. this is more likely to occur in people with diabetes, heart failure, kidney failure, or a suppressed immune system. anxiety is a common psychological side effect, with approximately 13–38% of icd patients reporting clinically significant anxiety. the primary etiological factors contributing to anxiety in icd patients have not been determined, however. depressive symptoms are also common, but the incidence of these problems has been shown to be similar to those observed in other cardiac patient groups, with approximately 24–41% of patients with icds experiencing depressive symptoms. problems in psychosocial adjustment to icds, including the experience of anxiety, among spouses or other romantic partners are also prevalent. this phenomenon may be related, at least in part, to shared shock anxiety and avoidance of physical and sexual contact.