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Updated: May 6, 2026

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

Published on: February 28, 2012

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Deactivation of implantable cardioverter-defibrillators at end of life

Stephen J Pettit1, Colette E Jackson, Roy S Gardner

  • 1Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE, UK. s.j.pettit@doctors.org.uk.

Future Cardiology
|November 5, 2013
PubMed

Insights

Planning for end-of-life care for patients with implantable cardioverter-defibrillators (ICDs) is crucial. Discussing ICD deactivation is often delayed, despite its importance in managing care near death.

Area of Science:

  • Cardiology
  • Palliative Care
  • Medical Ethics

Background:

  • All patients with implantable cardioverter-defibrillators (ICDs) will eventually die.
  • End-of-life care planning becomes relevant as patient conditions decline.
  • Concerns exist regarding futile shocks in patients nearing death.

Purpose of the Study:

  • To explore the implications of ICD deactivation in end-of-life care.
  • To address the uncertainty surrounding the impact of ICD deactivation on life expectancy.
  • To examine clinical practice and research directions for managing ICDs in terminally ill patients.

Main Methods:

  • Review of current clinical practices and literature regarding ICDs and end-of-life care.
  • Analysis of patient and clinician perspectives on ICD deactivation.
  • Discussion of ethical considerations and potential future research avenues.

Main Results:

  • The incidence of futile shocks in the final hours of life is estimated between 8-16%.
  • There is a broad consensus on the need to discuss ICD deactivation, but its effect on life expectancy remains uncertain.
  • Clinician reluctance and patient misconceptions contribute to delayed or absent discussions about ICD deactivation.

Conclusions:

  • The management of ICDs in patients approaching death presents a growing clinical challenge.
  • Further research is needed to clarify the impact of ICD deactivation on life expectancy and guide clinical practice.
  • Proactive and timely discussions about ICD deactivation are essential for comprehensive end-of-life care planning.

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