Why the study?
As patients with implantable cardiac defibrillators develop life-limiting conditions through ageing, frailty, and morbidity progression, approaching decisions to deactivate defibrillator function presents a clinical challenge.
Clinicians should proactively discuss ICD deactivation with patients developing life-limiting conditions to prevent distressing shocks at the end of life, while respecting patient autonomy and legal frameworks.
Requires proactive ICD deactivation planning in frail patients with life-limiting illness; leaves open standardized protocols and prospective data.
Implantable cardiac defibrillators are a key component in preventing sudden cardiac death for patients with life-threatening arrhythmias. Through ageing, frailty and the progression of cardiac and non-cardiac morbidity, many will develop a 'life-limiting' condition. This raises the challenge of how to approach making decisions to deactivate the defibrillator function. This article discusses the background to deactivation of implantable cardioverter defibrillators and the practical considerations for different circumstances.
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Bahl et al. (2020) studied this question.
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