Related Experiment Video

Updated: May 21, 2026

Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure
08:20

Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure

Published on: January 18, 2021

ICD deactivation: review of literature and clinical recommendations

Joanne L Thanavaro1

  • 1St Louis University, School of Nursing, St Louis, MO 63104, USA. jthanava@slu.edu

Clinical Nursing Research
|May 31, 2012
PubMed

Insights

Deactivating implanted cardioverter defibrillators (ICDs) at the end of life can prevent suffering and align care with patient wishes. This review addresses barriers and guidelines for ICD deactivation in terminally ill patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Palliative Care

Background:

  • Implanted cardioverter defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
  • Patient mortality is inevitable, regardless of ICD implantation.
  • ICDs may prolong suffering at the end of life by preventing sudden cardiac death and causing pain from shocks.

Purpose of the Study:

  • To review literature on barriers to deactivating ICDs.
  • To summarize Heart Rhythm Society guidelines for ICD management in end-of-life care.
  • To inform clinical practice regarding ICD deactivation.

Main Methods:

  • Focused literature review.
  • Synthesis of recommendations from the Heart Rhythm Society Consensus Statement.

Main Results:

  • Barriers to ICD deactivation exist, including ethical, legal, and communication challenges.
  • The Heart Rhythm Society provides recommendations for managing ICDs in patients nearing end of life.
  • Deactivation can align with patient autonomy and improve end-of-life comfort.

Conclusions:

  • Addressing barriers to ICD deactivation is essential for patient-centered end-of-life care.
  • Clinical guidelines support the withdrawal of ICD therapy when appropriate.
  • Facilitating informed discussions about ICD deactivation can improve patient and family experiences.

More Related Videos

Direct-current Stimulation and Multi-electrode Array Recording of Seizure-like Activity in Mice Brain Slice Preparation09:39

Direct-current Stimulation and Multi-electrode Array Recording of Seizure-like Activity in Mice Brain Slice Preparation

Published on: June 7, 2016

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Electroconvulsive Therapy01:30

Electroconvulsive Therapy

Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early years,...
Therapeutic Drug Monitoring: Overview and Classification01:16

Therapeutic Drug Monitoring: Overview and Classification

Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...