Patient decision-making in left ventricular assist devices for destination therapy

Background: Heart failure is a common life-limiting disease. A destination therapy for people who will not have a heart transplant is a left ventricular assist device. Aims: To discover how patients who have a left ventricular assist device for destination therapy make decisions about their healthcare after implantation of the device. Methods: A descriptive qualitative design with semi-structured, in-depth interviews with 11 participants who are living with a left ventricular assist device for destination therapy. Findings: People with a left ventricular assist device felt they had ‘no choice’ when making decisions about their healthcare. Conclusion: Engaging with patients to contemplate present and future healthcare decisions is a complex process that includes cognitive processes within the patient. Clinicians need to be aware that a gap may occur between what is said and what is heard in communication.