Complexities of Defibrillator Deactivation
Authors: Nathan E. Goldstein
Journal: Annals of Internal Medicine (2010)

Letters20 July 2010Complexities of Defibrillator DeactivationNathan E. Goldstein, MD, Melissa Carlson, MBA, PhD, and Jean S. Kutner, MD, MSPHNathan E. Goldstein, MDFrom Mount Sinai School of Medicine, New York, NY 10029, and University of Colorado Denver School of Medicine, Aurora, CO 80045.Search for more papers by this author, Melissa Carlson, MBA, PhDFrom Mount Sinai School of Medicine, New York, NY 10029, and University of Colorado Denver School of Medicine, Aurora, CO 80045.Search for more papers by this author, and Jean S. Kutner, MD, MSPHFrom Mount Sinai School of Medicine, New York, NY 10029, and University of Colorado Denver School of Medicine, Aurora, CO 80045.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-2-201007200-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Drs. Dev and Galanos's thoughtful response to our article. The goal of our work has always been to encourage patient–clinician communication about ICD deactivation to ensure that patients and families can make informed choices that are consistent with their values and desires for care. As such, we do not suggest requiring deactivation of devices in all patients and encourage physicians to respect patient autonomy when it comes to ICD management—even if, in the clinician's mind, the patient's decision seems to be counterintuitive. Drs. Dev and Galanos's comments about patients not always deciding to deactivate an ICD ...References1. Goldstein NE, Lampert R, Bradley E, Lynn J, Krumholz HM. Management of implantable cardioverter defibrillators in end-of-life care. Ann Intern Med. 2004;141:835-8. [PMID: 15583224] LinkGoogle Scholar2. Dunbar SB. Psychosocial issues of patients with implantable cardioverter defibrillators. Am J Crit Care. 2005;14:294-303. [PMID: 15980420] CrossrefMedlineGoogle Scholar3. Sears SF, Conti JB. Quality of life and psychological functioning of icd patients. Heart. 2002;87:488-93. [PMID: 11997430] CrossrefMedlineGoogle Scholar4. 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 Scholar5. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA. 2003;289:2387-92. [PMID: 12746362] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Nathan E. Goldstein, MD; Melissa Carlson, MBA, PhD; Jean S. Kutner, MD, MSPHAffiliations: From Mount Sinai School of Medicine, New York, NY 10029, and University of Colorado Denver School of Medicine, Aurora, CO 80045.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Implantable Cardioverter Defibrillators in End-of-Life Care Nathan E. Goldstein , Rachel Lampert , Elizabeth Bradley , Joanne Lynn , and Harlan M. Krumholz Brief 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 Sandesh Dev and Anthony N. Galanos , for the Duke Supportive Cardiology Group Metrics 20 July 2010Volume 153, Issue 2Page: 134KeywordsCardiovascular therapyCaregiversConflicts of interestForecastingHeart failureImplantable cardioverter defibrillatorsPatientsQuality of life ePublished: 20 July 2010 Issue Published: 20 July 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...