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Related Experiment Video

Updated: May 6, 2026

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[The ICD in the terminal stage].

Froukje S Boukes1, Tjerk Wiersma

  • 1Voormalige huisartsenpraktijk Walma en Boukes, Schoonhoven.

Nederlands Tijdschrift Voor Geneeskunde
|October 25, 2013
PubMed
Summary

Implantable cardioverter-defibrillators (ICDs) can disrupt end-of-life care. Patients need clear information on ICD deactivation, and physicians must discuss this proactively to honor patient wishes during terminal illness.

Area of Science:

  • Cardiology
  • Palliative Care
  • Medical Ethics

Background:

  • Implantable cardioverter-defibrillators (ICDs) are crucial for preventing sudden cardiac death from ventricular fibrillation.
  • The prevalence of ICDs is increasing globally, necessitating a greater focus on their long-term management and patient experience.

Observation:

  • ICD shocks can significantly disrupt the dying process for terminally ill patients.
  • Informed consent discussions at the time of ICD implantation often do not adequately address end-of-life shock potential.

Findings:

  • Physicians bear the responsibility for proactive communication regarding ICD deactivation as death approaches.
  • The decision to deactivate an ICD is complex, influenced by personal patient wishes and challenging even with thorough information.

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Implications:

  • Open communication about ICD deactivation is essential for respecting patient autonomy and improving end-of-life care.
  • Establishing accessible deactivation procedures, including in-home options, is vital for patient comfort and reducing healthcare burdens.