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

Jennifer Miller, Misook Chung, Farshid Etaee, Muna Hammash, Ingela Thylen, Martha Biddle, Samy Elayi, Mary Czarapata, Samantha McEvedy, Jan Cameron, Christine Haedtke, Chantal Ski, David, R. Thompson , Debra Moser

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Abstract

Background:Guidelines for device-based therapy of cardiac rhythm abnormalities were updated in 2008including discussions prior to implantation with implantable cardioverter defibrillator (ICD) recipientsregarding 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, Atti-tudes, and Knowledge of EOL.Results:Of the 240 ICD recipients, 76% reported that they have never had discussions with their health careprovider regarding the withdrawal of defibrillation therapy. A total of 38% believed that turning off the ICDshocks was the same as active euthanasia and that disabling defibrillation therapy required surgical interven-tion; 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 thepatients' 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
Volume48
Issue number4
Early online date07 May 2019
DOIs
Publication statusPublished - Jul 2019

Keywords

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

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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    Miller, J., Chung, M., Etaee, F., Hammash, M., Thylen, I., Biddle, M., Elayi, S., Czarapata, M., McEvedy, S., Cameron, J., Haedtke, C., Ski, C., Thompson , D. R., & Moser, D. (2019). Missed opportunities! End of life decision making and discussions in implantable cardioverter defibrillator recipients. Heart and Lung, 48(4), 313-319. https://doi.org/10.1016/j.hrtlng.2019.04.006