Urgent implantable cardioverter defibrillator deactivation by unconventional means

Increasing numbers of patients are receiving implantable cardioverter defibrillators (ICDs); the devices remain fully functional in most terminally ill patients at the time of death. We describe a case of a terminally ill patient with repeated defibrillations who requested urgent ICD deactivation. Nonmedical magnets available in the facility were used to deactivate the ICD and terminate the defibrillations. We then studied various magnetic field sources commonly available in homes, such as ceramic magnets, cell phones, computer hard drives, headsets, and earbuds that potentially may be used to temporarily deactivate an ICD until a device technician is available for reprogramming. We conclude that commonly available magnetic sources may potentially be used to deactivate an ICD. The clinical usefulness of this is speculative and limited to conditions when the need to turn off the device is urgent, and a delay in reprogramming is anticipated.