Related Experiment Video
Updated: Feb 27, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Implantable cardioverter defibrillator knowledge and end-of-life device deactivation: A cross-sectional survey
Samantha M McEvedy1, Jan Cameron2, Eugene Lugg3
11 School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
Insights
Many patients with implantable cardioverter defibrillators (ICDs) lack knowledge about deactivation. Insufficient ICD knowledge is linked to reluctance to discuss end-of-life deactivation, highlighting a need for better patient education.
Area of Science:
- Cardiology
- Geriatrics
- Palliative Care
Background:
- End-of-life discussions regarding implantable cardioverter defibrillator (ICD) deactivation are often delayed, despite recommendations for early and ongoing conversations.
- Many ICDs remain active in patients nearing the end of life, indicating a gap in care.
Purpose of the Study:
- To investigate the relationship between patients' knowledge of ICDs, their personal characteristics, and their attitudes toward ICD deactivation.
- To identify factors associated with insufficient understanding of ICD deactivation among patients.
Main Methods:
- A cross-sectional survey was conducted using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire.
- Participants (n=270) were categorized based on their knowledge level (insufficient vs. sufficient) and compared.
Main Results:
- Patients with insufficient ICD knowledge (29%) were older, less likely to be Caucasian, had fewer ICD shocks, and showed higher rates of mild cognitive impairment.
- Insufficient knowledge was significantly associated with an unwillingness to discuss ICD deactivation, particularly near the end of life.
Conclusions:
- Older patients and those with mild cognitive impairment often possess limited knowledge about ICD deactivation.
- The findings suggest critical "teachable moments" for initiating deactivation discussions throughout a patient's treatment.
- An interdisciplinary approach, including family members, is crucial for timely and effective end-of-life deactivation conversations.
Background:
End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days.
Aim:
To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation.
Design:
Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire. Participants were classified as insufficient or sufficient implantable cardioverter defibrillator knowledge and the two groups were compared.
Setting/Participants:
Implantable cardioverter defibrillator recipients ( n = 270, mean age 61 ± 14 years; 73% male) were recruited from cardiology and implantable cardioverter defibrillator clinics attached to two tertiary hospitals in Melbourne, Australia, and two in Kentucky, the United States.
Results:
Participants with insufficient implantable cardioverter defibrillator knowledge ( n = 77, 29%) were significantly older (mean age 66 vs 60 years, p = 0.001), less likely to be Caucasian (77% vs 87%, p = 0.047), less likely to have received implantable cardioverter defibrillator shocks (26% vs 40%, p = 0.031), and more likely to have indications of mild cognitive impairment (Montreal Cognitive Assessment score <24: 44% vs 16%, p < 0.001). Insufficient implantable cardioverter defibrillator knowledge was associated with attitudes suggesting unwillingness to discuss implantable cardioverter defibrillator deactivation, even during the last days towards end of life ( p < 0.05).
Conclusion:
Implantable cardioverter defibrillator recipients, especially those who are older or have mild cognitive impairment, often have limited knowledge about implantable cardioverter defibrillator deactivation. This study identified several potential teachable moments throughout the patients' treatment trajectory. An interdisciplinary approach is required to ensure that discussions about implantable cardioverter defibrillator deactivation issues are initiated at appropriate time points, with family members ideally also included.
More Related Videos
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
07:41Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:23Cardiopulmonary Resuscitation III: AED Use
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:26Cardiac Catheterization IV: Nursing Management
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:24Cardiac Catheterization III: Left Heart Catheterization