I read with interest the recent article by Kirkpatrick et al
1
regarding deactivation of implantable cardioverter–defibrillators (ICDs) in end-of-life
care. The authors surveyed 278 patients regarding their attitude to ICDs at the end
of life. They specifically asked about advance directives and patient opinion on whether
subjects defined ICD deactivation as physician-assisted suicide. Half of patients
had some form of advance directive, but only 3 had included a plan for their ICD at
the end of life. 44% of patients in 2009 and 12% of patients in 2010 considered ICD
deactivation to be physician-assisted suicide. This was a worrying statistic because
physician-assisted suicide is illegal in most parts of the world and most states in
the United States. Patients interviewed in 2010 were more likely to want their ICD
deactivated at the end of life than those interviewed in 2009 (49% vs 0%).To read this article in full you will need to make a payment
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References
- Deactivation of implantable cardioverter defibrillators in terminal illness and end of life care.Am J Cardiol. 2012; 109: 91-94
- Implantable cardioverter-defibrillator recipient attitudes towards device deactivation: how much do patients want to know?.Pacing Clin Electrophysiol. 2011; 34: 1628-1633
- HRS expert consensus statement on the management of cardiovascular implantable electronic devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy this document was developed in collaboration with the American College of Cardiology (ACC), American Geriatrics Society (AGS), American Academy of Hospice and Palliative Medicine (AAHPM), American Heart Association (AHA), and the European Heart Rhythm Association (EHRA).Heart Rhythms. 2010; 7: 1008-1026
Article info
Publication history
Received:
February 10,
2012
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Deactivation of Implantable Cardioverter Defibrillators in Terminal Illness and End of Life CareAmerican Journal of CardiologyVol. 109Issue 1
- PreviewCardiology professional societies have recommended that patients with cardiovascular implantable electronic devices complete advance directives (ADs). However, physicians rarely discuss end of life handling of implantable cardioverter defibrillators (ICDs), and standard AD forms do not address the presence of ICDs. We conducted a telephone survey of 278 patients with an ICD from a large, academic hospital. The average period since implantation was 5.15 years. More than 1/3 (38%) had been shocked, with a mean of 4.69 shocks.
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