PURPOSE OF REVIEW: @entity712 is a significant public health concern around the world. Implantable cardioverter defibrillators with or without cardiac resynchronization therapy (CRT-D) have proven survival benefit. As @entity1 progress to end-stage disease, management shifts to palliative care, and cardiologists are often confronted with how to best manage these devices. RECENT FINDINGS: Studies suggest that up to one-third of @entity1 with an implantable cardioverter defibrillator receive @entity158 in the last 24h of life. Disabling pacing or resynchronization devices may further weaken the heart function and expedite @entity204 , particularly if the @entity1 has no underlying @entity67 . Is it ethical or legal to discontinue functions of the implantable device? The discussion and the decision to be made are whether to continue both pacing and @entity591 therapies, disable @entity591 therapies while maintaining pacing, or discontinue both. SUMMARY: The decision to disable all or parts of the device function is ultimately up to the @entity1 . To avoid @entity158 near the end of life, it is recommended that @entity591 therapies be turned off when the @entity1 is being treated palliatively. After informed discussion, withdrawing the resynchronization or pacing device option is also acceptable if requested by the @entity1 regardless of the potential outcomes.

End of life decisions in XXXX : to turn off the intracardiac device or not?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity712 :: ('MESH:D006333', 'Disease') :: ['Heart failure'] @entity591 :: ('MESH:D013610', 'Disease') :: ['tachyarrhythmia'] @entity158 :: ('MESH:D010146', 'Disease') :: ['painful shocks'] @entity67 :: ('MESH:D018754', 'Disease') :: ['ventricular rhythm'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity712 :: (MESH:D006333,Disease) :: ['heart failure']
