Related Experiment Video
Updated: Feb 12, 2026
06:14
Translational Rabbit Model of Chronic Cardiac Pacing
Published on: January 6, 2023
3.1K
Palliative pacemaker deactivation for a pacing-dependent patient
1University College London Hospitals NHS Foundation Trust, London, UK h.petra@nhs.net.
BMJ Supportive & Palliative Care
|February 10, 2026
Summary
A pacemaker was legally deactivated in a frail, elderly patient with heart failure, allowing natural death. The patient remained comfortable and passed away peacefully 18 hours after withdrawal of pacing.
Area of Science:
- Cardiology
- Medical Ethics
- Palliative Care
Background:
- Elderly patient with severe heart failure and third-degree atrioventricular block dependent on a pacemaker.
- Patient's request for pacemaker deactivation to allow natural death from cardiac pathology.
Purpose of the Study:
- To describe the case of a patient-requested pacemaker deactivation in end-of-life care.
- To explore the ethical and practical considerations of withdrawing cardiac pacing treatment.
Main Methods:
- A 135-day consultation period preceded the legal deactivation of the pacemaker.
- Palliative care, including opioid and benzodiazepine administration, was provided post-deactivation.
Main Results:
- The patient experienced bradycardia and hypoxia but remained comfortable and conversant initially.
- He died peacefully 18 hours after pacemaker deactivation, with palliative measures managed.
Conclusions:
- Legal and ethical withdrawal of cardiac pacing is feasible in end-of-life care.
- Palliative sedation and symptom management are crucial for patient comfort during pacemaker deactivation.
Related Concept Videos
01:25Deactivation Processes: Jablonski Diagram
1.9K
Luminescence, the emission of light by a substance that has absorbed energy, is a process that involves the interaction of molecules with light. The energy-level diagram, or Jablonski diagram, is a graphical representation of these interactions, illustrating the various states and transitions a molecule can undergo. In a typical Jablonski diagram, the lowest horizontal line represents the ground-state energy of the molecule, which is usually a singlet state. This state represents the energies...
1.9K
01:24ortho–para-Directing Deactivators: Halogens
6.8K
Halogens are ortho–para directors. They are more electronegative than carbon. Therefore, as ring substituents, they can withdraw electrons through the inductive effect and deactivate the aromatic ring towards electrophilic substitution. Halogens also have an electron-donating resonance effect on the ring, which influences the orientation of the incoming electrophile. If an electrophile attacks at the ortho or the para position, the halogen donates electrons and stabilizes the intermediate...
6.8K
01:21Frequency-dependent Selection
24.2K
When the fitness of a trait is influenced by how common it is (i.e., its frequency) relative to different traits within a population, this is referred to as frequency-dependent selection. Frequency-dependent selection may occur between species or within a single species. This type of selection can either be positive—with more common phenotypes having higher fitness—or negative, with rarer phenotypes conferring increased fitness.
24.2K
01:17Drug Dependence
1.7K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.7K
01:19Contact-dependent Signaling
47.6K
Contact-dependent signaling, as the name suggests, requires that communicating cells be in direct contact with each other. This is achieved either through receptor-ligand interactions or by specialized cytoplasmic channels that allow the flow of small molecules between cells. In animal cells, channels called gap junctions facilitate contact-dependent signaling in certain tissues, whereas, plasmodesmata perform a similar function in plants.
Gap Junctions
In animal cells, gap junctions are formed...
Gap Junctions
In animal cells, gap junctions are formed...
47.6K
01:13meta-Directing Deactivators: –NO2, –CN, –CHO, –CO2R, –COR, –CO2H
6.8K
All meta-directing substituents are deactivating groups. These substituents withdraw electrons from the aromatic ring, making the ring less reactive toward electrophilic substitution. For example, the nitration of nitrobenzene is 100,000 times slower than that of benzene because of the deactivating effect of the nitro group. The first step in an electrophilic aromatic substitution is the addition of an electrophile to form a resonance-stabilized carbocation. The energy diagrams for...
6.8K