Key result
Managing end-of-life implantable cardiac devices requires increased collaboration between cardiovascular and palliative care specialists.
Why the study?
As the volume of implantable cardiac device implants increases and more patients reach end of life, management issues in the palliative care setting become more pertinent.
Highlights the need for collaboration between cardiovascular and palliative care specialists for managing and de-activating implantable cardiac devices at the end of life.
Encourages cross-specialty protocols for end-of-life device care; leaves open prospective trials to define optimal models.
In the past 10 years, implantable devices that augment cardiac function and/or treat lethal arrhythmias have become standard therapies for end-stage heart failure. These devices include implantable cardioverter defibrillators (ICDs), bi-ventricular pacemakers for cardiac resynchronization therapy (CRT) and ventricular assist devices (VADs). Each of these devices presents unique challenges in the palliative care setting. As the volume of device implants increases and more patients with these devices reach the end of their lives, device management issues become more pertinent in the palliative care setting. This review will discuss the nature and differences of ICDs, CRT devices and VADs, specific issues pertaining to device de-activation, and strategies for management at patients' end of life. Provision of high-quality care for these patients will require increased collaboration between cardiovascular and palliative care specialists.
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Kirkpatrick et al. (2008) conducted a review in End-stage heart failure. Management and de-activation of implantable cardiac devices (ICDs, CRT, VADs) was evaluated. Management and de-activation of implantable cardiac devices at the end of life requires increased collaboration between cardiovascular and palliative care specialists.
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