Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients

Jennifer L. Miller, Misook L. Chung, Farshid Etaee, Muna Hammash, Ingela Thylén, Martha J. Biddle, Samy C. Elayi, Mary M. Czarapata, Samantha McEvedy, Jan Cameron, Christine A. Haedtke, Chantal F. Ski, David R. Thompson, Debra K. Moser

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)


Background: Guidelines for device-based therapy of cardiac rhythm abnormalities were updated in 2008 including discussions prior to implantation with implantable cardioverter defibrillator (ICD) recipients regarding end-of-life (EOL) choices. Objectives: To explore patients’ knowledge of the function of the ICD at EOL. Methods: ICD recipients from Central Kentucky and Melbourne, Australia completed the Experiences, Attitudes, and Knowledge of EOL. Results: Of the 240 ICD recipients, 76% reported that they have never had discussions with their health care provider regarding the withdrawal of defibrillation therapy. A total of 38% believed that turning off the ICD shocks was the same as active euthanasia and that disabling defibrillation therapy required surgical intervention; 37% believed that once defibrillation was disabled, it could not be enabled again. Conclusions: Adherence to guidelines regarding EOL discussions with ICD recipients was minimal from the patients' perspective. Most patients may hold alarming misperceptions that could interfere with optimal EOL care.

Original languageEnglish
Pages (from-to)313-319
Number of pages7
JournalHeart and Lung
Issue number4
Publication statusPublished - Aug 2019


  • End of life
  • End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire
  • Hospital Anxiety and Depression Scale
  • Implantable cardioverter defibrillator
  • Newest Vital Sign

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