Patients' openness to discussing implantable cardioverter defibrillator deactivation at end of life: a cross-sectional study

Kyoung Suk Lee, Oonjee Oh, Jennifer Miller, Muna Hammash, David R. Thompson, Chantal F. Ski, Jan Cameron, Seon Young Hwang, Debra K. Moser

Research output: Contribution to journalArticleResearchpeer-review


AIMS: It is recommended that patients and clinicians discuss end-of-life deactivation of their implantable cardioverter defibrillator (ICD) prior to device implantation and throughout the illness trajectory to facilitate shared decision-making. However, such discussions rarely occur, and little is known about patients' openness to this discussion. The purpose of this study was to explore factors associated with patients' openness to discussing end-of-life ICD deactivation with clinicians. METHODS AND RESULTS: This cross-sectional study recruited 293 patients with an ICD from outpatient clinics in the USA, Australia, and South Korea. Patients were classified into an open or resistant group based on their desire to discuss device deactivation at end of life with clinicians. Multivariable logistic regression was used to explore factors related to patients' openness to this discussion.About half of the participants (57.7%) were open to discussing such issues with their clinicians. Factors related to patients' openness to discussing device deactivation at end of life were living with someone, not having severe comorbid conditions (cancer and/or chronic kidney disease), greater ICD knowledge, and more experience discussing end-of-life issues with clinicians (odds ratio: 0.479, 0.382, 1.172, 1.332, respectively). CONCLUSION: Approximately half of the ICD recipients were reluctant to discuss device deactivation at end of life with clinicians. Unmodifiable factors were their living arrangement and severe comorbidity. ICD knowledge and prior experience discussing end-of-life issues were potentially modifiable factors in the future. These factors should be addressed when assessing patients' readiness for a shared discussion about device deactivation at end of life.

Original languageEnglish
Pages (from-to)687-693
Number of pages7
JournalEuropean Journal of Cardiovascular Nursing
Issue number7
Publication statusPublished - Sept 2022


  • Cross-sectional studies
  • Implantable cardioverter defibrillators
  • Patient preference
  • Shared decision-making

Cite this