Deactivation of implantable cardioverter-defibrillator at end of life

Tomasz Grądalski; Małgorzata Smyczyńska

eISSN: 2081-2833
ISSN: 2081-0016

Medycyna Paliatywna/Palliative Medicine

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3/2015
vol. 7

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abstract:

Case report

Deactivation of implantable cardioverter-defibrillator at end of life

Tomasz Grądalski

,

Małgorzata Smyczyńska

Medycyna Paliatywna 2015; 7(3): 201–204

Online publish date: 2015/11/17

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Two cases of patients with advanced cancer and implanted cardioverter-defibrillator (ICD) were presented. In the terminal phase of their disease the ICD deactivation was performed: an emergency total deactivation in the last day of life in the former man and a selective deactivation of defibrillation/cardioversion function in the last weeks in the latter woman.

A model of ICD deactivation in palliative care was proposed. The selective deactivation is preferable to preserve the cardiac rhythm pacing, preventing painful resuscitation during agony. Emergency total deactivation is also the option, even in home hospice care. Shared decision and advance care planning in such cases can meet patients’ preferences and decrease the risk of the harmful therapy.

keywords:

Deactivation of implantable cardioverter-defibrillator at end of life

Tomasz Grądalski , Małgorzata Smyczyńska

sudden cardiac death, implantable cardioverter-defibrillator, palliative care, advance care planning

Tomasz Grądalski

,

Małgorzata Smyczyńska