['To identify correlates of impaired quality of life (QOL), anxiety, and depression in patients with an implantable cardioverter-defibrillator (ICD).', 'Surviving patients (n = 610) who received an ICD in our institution since 1989 completed the Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale. Mean age was 62.4 years with 18% females. In a multivariate logistic regression analysis, symptomatic heart failure was the most important correlate of impaired QOL (SF-36) across all eight subscales [odds ratios (ORs) ranging from 5.21 to 22.53)], whereas psychotropic medication, age, comorbidity, amiodarone, and ICD shocks all correlated to a lesser extent. Symptomatic heart failure was also the most dominant correlate of anxiety [OR 5.15 (3.08-8.63), P < 0.001] and depression [OR 6.82 (3.77-12.39), P < 0.001]. Implantable cardioverter-defibrillator shocks correlated less yet significantly with anxiety [OR 2.21 (1.32-3.72) P < 0.01] and depression [OR 2.00 (1.06-3.80), P < 0.05].'] Is symptomatic heart failure the most important clinical correlate of impaired quality of life , anxiety , and depression in implantable cardioverter-defibrillator patients : a single-centre , cross-sectional study in 610 patients?