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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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Patients' openness to discussing implantable cardioverter defibrillator deactivation at end of life: a

Kyoung Suk Lee1, Oonjee Oh1, Jennifer Miller2

  • 1College of Nursing, Seoul National University, 103 Daehak-ro, Jong-ro, Seoul 03080, South Korea.

European Journal of Cardiovascular Nursing
|January 12, 2022
PubMed

Insights

Many implantable cardioverter defibrillator (ICD) patients are open to discussing end-of-life deactivation. Factors like living situation, comorbidities, and prior discussions influence openness, highlighting areas for improved patient-clinician communication.

Area of Science:

  • Cardiology
  • Medical Ethics
  • Patient-Physician Communication

Background:

  • Discussions regarding end-of-life deactivation of implantable cardioverter defibrillators (ICDs) are recommended but rarely occur.
  • Understanding patient willingness to discuss ICD deactivation is crucial for shared decision-making.

Purpose of the Study:

  • To explore factors associated with patients' openness to discussing end-of-life ICD deactivation with clinicians.

Main Methods:

  • A cross-sectional study involving 293 patients with ICDs in the USA, Australia, and South Korea.
  • Patients were categorized as open or resistant to discussing end-of-life deactivation.
  • Multivariable logistic regression analyzed factors related to openness.

Main Results:

  • 57.7% of patients were open to discussing ICD deactivation.
  • Openness was associated with living with someone, absence of severe comorbidities (cancer/CKD), greater ICD knowledge, and prior end-of-life discussions.

Conclusions:

  • Half of ICD recipients are reluctant to discuss deactivation.
  • Living arrangements and comorbidities are unmodifiable factors; ICD knowledge and prior discussions are modifiable.
  • Assessing patient readiness for shared discussions on deactivation is essential.
Abstract

Keywords:
Cross-sectional studiesImplantable cardioverter defibrillatorsPatient preferenceShared decision-making

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