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.