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Updated: Jul 19, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

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

Published on: February 28, 2012

Putting the "Informed" in the informed consent process for implantable cardioverter-defibrillators: Addressing the

Arnold R Eiser1,2, James N Kirkpatrick3, Kristen K Patton3

  • 1Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.

Pacing and Clinical Electrophysiology : PACE
|January 25, 2018
PubMed

Insights

Informed consent for implantable cardioverter defibrillators (ICDs) is complex for elderly patients. Discussions should include future deactivation or nonreplacement options to align with patient values and changing conditions.

Area of Science:

  • Cardiology
  • Medical Ethics
  • Geriatric Medicine

Background:

  • Implantable cardioverter defibrillators (ICDs) present complex management challenges, particularly for multimorbid elderly patients undergoing primary prevention.
  • Fully informed consent for ICD implantation is difficult to achieve, especially considering potential future deactivation or nonreplacement needs.

Purpose of the Study:

  • To address the complexities of informed consent for ICDs in elderly patients.
  • To emphasize the importance of discussing future device deactivation or nonreplacement at the time of initial implant and at follow-up intervals.

Main Methods:

  • Review of Heart Rhythm Society recommendations regarding ICD consent.
  • Analysis of challenges in decision-making capacity for elderly patients and the role of surrogate decision-makers.
  • Exploration of the utility of information and decision aids to enhance patient understanding.

Main Results:

  • Current consent procedures may not adequately prepare patients for future decisions regarding ICD deactivation or nonreplacement.
  • Elderly patients may lack the capacity or will to make complex decisions when their clinical condition changes.
  • Information and decision aids can improve understanding and facilitate value-consistent choices.

Conclusions:

  • Informed consent for ICDs requires proactive discussion of potential future deactivation or nonreplacement, especially for elderly patients.
  • Integrating discussions about changing clinical conditions and device utility into the initial consent process is crucial.
  • Enhanced communication and decision support empower patients and surrogates to make treatment decisions aligned with personal values.

Keywords:
ICDgoals of Careinformed consentshared decision making

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