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Updated: May 4, 2026
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Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
Published on: February 17, 2018
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[Dying with/despite a pacemaker]
1Medizinische Klinik I, Universitätsklinikum Aachen, Aachen, Deutschland.
Medizinische Klinik, Intensivmedizin Und Notfallmedizin
|January 4, 2014
Summary
Intensive care unit (ICU) physicians must understand the ethical and legal issues surrounding cardiovascular implantable electronic device (CIED) deactivation in dying patients. Patient consent is essential for deactivating devices like pacemakers and implantable cardioverter-defibrillators (ICDs).
Area of Science:
- Cardiology
- Medical Ethics
- Intensive Care Medicine
Context:
- Cardiovascular implantable electronic devices (CIEDs) are increasingly common in intensive care unit (ICU) patients.
- Physicians face complex clinical, ethical, and legal challenges regarding CIEDs in end-of-life care.
- Therapeutic goals often shift in patients with prolonged illness trajectories.
Purpose:
- To highlight the critical need for ICU physicians to be aware of the implications of CIEDs in end-of-life care.
- To address the ethical and legal complexities associated with CIED deactivation.
- To emphasize the importance of patient consent and legal awareness in deactivation decisions.
Summary:
- Deactivation of CIEDs, including pacemakers and implantable cardioverter-defibrillators (ICDs), presents significant ethical and legal considerations for ICU physicians.
- While ethical permissibility for ICD deactivation in dying patients is generally agreed upon, patient consent is mandatory.
- Practices and attitudes towards pacemaker versus ICD deactivation vary, necessitating awareness of specific device types and legal frameworks.
Impact:
- Informed decision-making regarding CIED deactivation can improve end-of-life care for patients and provide support for physicians.
- Promoting transparency and ethical/legal guidance is crucial for navigating these difficult decisions.
- Ensuring patient autonomy and respecting individual wishes are paramount in managing CIEDs during terminal illness.
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