Deactivation of implanted cardioverter-defibrillators at the end of life: results of the EHRA survey

Europace. 2010 Aug;12(8):1176-7. doi: 10.1093/europace/euq272.

Abstract

This survey assesses the current opinion on and practice of the management of terminally ill patients with implanted cardioverter-defibrillators (ICDs) in 47 large European centres. The principal findings of this survey were that most physicians (62%) from European centres who responded to this survey would consider deactivating ICDs at the patient's end of life. In these circumstances, multiple appropriate ICD shocks may be an indication to deactivate an ICD (83% positive answers). Remote deactivation by a remote monitoring system is not considered appropriate by 68%. Practices of deactivating procedure differ and approach to standardized clinical scenarios is inhomogeneous. Patients are provided with surprisingly little information on the possibility of deactivation of ICDs since this subject is only actively discussed in 4% of centres.

MeSH terms

  • Death
  • Defibrillators, Implantable / ethics
  • Defibrillators, Implantable / statistics & numerical data*
  • Europe
  • Female
  • Health Care Surveys*
  • Humans
  • Male
  • Palliative Care / ethics
  • Palliative Care / statistics & numerical data*
  • Patient Participation / statistics & numerical data
  • Surveys and Questionnaires
  • Terminal Care / ethics
  • Terminal Care / statistics & numerical data*
  • Withholding Treatment / ethics
  • Withholding Treatment / statistics & numerical data*