Deactivation of pacemakers and implantable

Prog Cardiovasc Dis · Nov 2012

Review

Deactivation of pacemakers and implantable cardioverter-defibrillators.

Cardiac implantable electrical devices (CIEDs), including pacemakers (PMs) and implantable cardioverter-defibrillators (ICDs), are the most effective treatment for life-threatening arrhythmias. Patients or their surrogates may request device deactivation to avoid prolongation of the dying process or in other settings, such as after device-related complications or with changes in health care goals. ⋯ This review outlines the ethical and legal principles supporting CIED deactivation, centered upon patient autonomy and authority over their own medical treatment. The empirical literature describing stakeholder views and experiences surrounding CIED deactivation is described, along with implications of these studies for future research surrounding the care of patients with CIEDs.

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- Daniel B Kramer, Susan L Mitchell, and Dan W Brock.
- Hebrew SeniorLife Institute for Aging Research, Boston, MA, USA. danielkramer@hsl.harvard.edu
- Prog Cardiovasc Dis. 2012 Nov 1;55(3):290-9.
AbstractCardiac implantable electrical devices (CIEDs), including pacemakers (PMs) and implantable cardioverter-defibrillators (ICDs), are the most effective treatment for life-threatening arrhythmias. Patients or their surrogates may request device deactivation to avoid prolongation of the dying process or in other settings, such as after device-related complications or with changes in health care goals. Despite published guidelines outlining theoretical and practical aspects of this common clinical scenario, significant uncertainty remains for both patients and health care providers regarding the ethical and legal status of CIED deactivation. This review outlines the ethical and legal principles supporting CIED deactivation, centered upon patient autonomy and authority over their own medical treatment. The empirical literature describing stakeholder views and experiences surrounding CIED deactivation is described, along with implications of these studies for future research surrounding the care of patients with CIEDs.Copyright © 2012 Elsevier Inc. All rights reserved.

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Deactivation of pacemakers and implantable cardioverter-defibrillators.

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