Key result
End-of-life ICD shocks affect ~33% of HF patients, driving the need for clear deactivation policies.
Why the study?
Implantable cardioverter defibrillators may cause burdensome shocks at the end of life in patients with heart failure, and clear policies for ICD deactivation are needed.
Health care organizations should implement clear policies for ICD deactivation to prevent burdensome shocks and integrate palliative care in end-stage heart failure.
May warrant consideration of ICD deactivation policies in end-stage HF; leaves open rigorous evaluation of their effect on outcomes.
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered. Health care organizations should have clear policies addressing ICD deactivation to provide for seamless integration of palliative care services throughout the course of heart failure. These policies should empower nurses to activate resources in a timely manner and should clearly outline processes for ICD deactivation.
No takes yet. Share an insight, caveat, or question.
Destiny R. Brady (2016) conducted a review in End-stage heart failure. Implantable cardioverter defibrillator (ICD) deactivation was evaluated. Implantable cardioverter defibrillator shocks affect up to one-third of heart failure patients at the end of life, highlighting the need for clear organizational policies for ICD deactivation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: