Complexities of Defibrillator Deactivation

Letters20 July 2010Complexities of Defibrillator DeactivationSandesh Dev, MD and Anthony N. Galanos, MA, MD, for the Duke Supportive Cardiology GroupSandesh Dev, MDFrom Duke University Medical Center, Durham, NC 27710.Search for more papers by this author and Anthony N. Galanos, MA, MDFrom Duke University Medical Center, Durham, NC 27710.Search for more papers by this author, for the Duke Supportive Cardiology GroupSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-2-201007200-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We strongly agree with Goldstein and colleagues' (1) conclusion that hospice may improve quality of care if patients with implantable cardioverter-defibrillators (ICDs) are identified and ICD deactivation is addressed. In our own hospital-based heart failure cardiology and palliative care practices, we always address ICD deactivation before discharging patients to hospice care. However, given the complexity and difficulty of decision making for families and caregivers during transitions in care, some patients are not ready to deactivate their ICD at the time of hospital discharge. We appreciate that hospices do accept patients who have functioning ICDs with the presumed ...References1. Goldstein N, Carlson M, Livote E, Kutner JS. Brief communication: management of implantable cardioverter-defibrillators in hospice: A nationwide survey. Ann Intern Med. 2010;152:296-9. [PMID: 20194235] LinkGoogle Scholar2. Bain KT, Maxwell TL, Strassels SA, Whellan DJ. Hospice use among patients with heart failure. Am Heart J. 2009;158:118-25. [PMID: 19540401] CrossrefMedlineGoogle Scholar3. Goldstein NE, Mehta D, Siddiqui S, Teitelbaum E, Zeidman J, Singson M, et al. “That's like an act of suicide” patients' attitudes toward deactivation of implantable defibrillators. J Gen Intern Med. 2008;23 Suppl 1 7-12. [PMID: 18095037] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sandesh Dev, MD; Anthony N. Galanos, MA, MDAffiliations: From Duke University Medical Center, Durham, NC 27710.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBrief Communication: Management of Implantable Cardioverter-Defibrillators in Hospice: A Nationwide Survey Nathan Goldstein , Melissa Carlson , Elayne Livote , and Jean S. Kutner Complexities of Defibrillator Deactivation Nathan E. Goldstein , Melissa Carlson , and Jean S. Kutner Metrics Cited byThe Deactivation of Implantable Cardioverter-DefibrillatorsEffective communication and ethical consent in decisions related to ICDsImplantable cardiac defibrillators and end-of-life care—Time for reflection, deliberation and debate? 20 July 2010Volume 153, Issue 2Page: 133-134KeywordsDecision makingForecastingHealth care qualityHeart diseasesHeart failureImplantable cardioverter defibrillatorsLength of stayMedicarePalliative carePatients ePublished: 20 July 2010 Issue Published: 20 July 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Topic: Cardiac pacing and defibrillation studies
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences