[The ICD in the terminal stage]

ICDs are used to prevent sudden death caused by ventricular fibrillation. The number of patients with an ICD will keep growing. ICD shocks can severely disturb the dying process in terminally ill patients. Patients must be informed about this at the time of ICD implantation. The attending physician is responsible for proactive communication regarding deactivation when death is expected imminently. The decision to deactivate the ICD depends on personal wishes, and has proved to be difficult even if the patient has been well informed. Deactivation at home must be available so that severely ill patients do not need to travel to a hospital.