Deactivating Implantable Cardioverter Defibrillators
Authors: James M. Beattie, Michael J. Connolly, John E. Ellershaw
Journal: Annals of Internal Medicine (2005)

Letters1 November 2005Deactivating Implantable Cardioverter DefibrillatorsJames M. Beattie, MD, Michael J. Connolly, MPhil, RGN, and John E. Ellershaw, MAJames M. Beattie, MDFrom Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.Search for more papers by this author, Michael J. Connolly, MPhil, RGNFrom Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.Search for more papers by this author, and John E. Ellershaw, MAFrom Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-9-200511010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The review by Berger (1) highlights the complex end-of-life issues posed by the presence of ICDs. This dilemma is particularly difficult for those physicians treating patients who have advanced heart failure, a group that is receiving implantable devices at an increasing rate and whose prognosis is ambiguous. The American College of Cardiology/American Heart Association practice guidelines for chronic heart failure offer the consensus view that such devices are of little benefit in those patients with New York Heart Association class IV symptoms typical of end-stage disease (2).We agree with Berger that formal guidelines do not exist ...References1. Berger JT. The ethics of deactivating implanted cardioverter defibrillators. Ann Intern Med. 2005;142:631-4. [PMID: 15838070] LinkGoogle Scholar2. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, et al. ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the International Society for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America. Circulation. 2001;104:2996-3007. [PMID: 11739319] MedlineGoogle Scholar3. Mueller PS, Hook CC, Hayes DL. Ethical analysis of withdrawal of pacemaker or implantable cardioverter-defibrillator support at the end of life. Mayo Clin Proc. 2003;78:959-63. [PMID: 12911044] CrossrefMedlineGoogle Scholar4. 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 Scholar5. Ellershaw JE, Wilkinson S. Care of the Dying: A Pathway to Excellence. London: Oxford Univ Pr; 2003. Google Scholar Author, Article, and Disclosure InformationAuthors: James M. Beattie, MD; Michael J. Connolly, MPhil, RGN; John E. Ellershaw, MAAffiliations: From Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.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 The Ethics of Deactivating Implanted Cardioverter Defibrillators Jeffrey T. Berger Deactivating Implantable Cardioverter Defibrillators Joanne Lynn Deactivating Implantable Cardioverter Defibrillators Jeffrey T. Berger Deactivating Implantable Cardioverter Defibrillators Heather M. Ross Metrics Cited byHow is life support withdrawn in intensive care units: A narrative reviewPalliative care in non-malignant diseaseHealth span or life span: The role of patient-reported outcomes in informing health policyPalliativmedizin und fortgeschrittene, nicht heilbare ErkrankungenEnd-of-life care conversations with heart failure patients: a systematic literature review and narrative synthesisPalliative care: Based on neither diagnosis nor prognosis, but patient and family need. Commentary on Chattoo and AtkinDifficult conversations and chronic heart failure: do you talk the talk or walk the walk? 1 November 2005Volume 143, Issue 9Page: 690-691KeywordsCardiovascular therapyConflicts of interestHeart diseasesHeart failureImplantable cardioverter defibrillatorsLongitudinal studiesPilot studiesResuscitationShock ePublished: 1 November 2005 Issue Published: 1 November 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. 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