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Patients' knowledge and opinions of ICDs during life, illness and at the time of death

11 April 2019
Volume 28 · Issue 7


Use of an implantable cardioverter defibrillator (ICD) is an established therapy for the prevention of sudden cardiac death. However, at the end of life, these devices can prolong the dying experience, causing physical and psychological trauma. Patients are often unaware of their options regarding ICD management at the end of their life, which highlights the need for health professionals to have these discussions with patients. This study aimed to identify patients' knowledge and opinions about their ICD and the factors influencing their knowledge and opinions. Of the 30 participants in this study, 59% had sufficient knowledge about ICDs. There was no relationship between knowledge and time since implantation (p=0.11). A relationship existed between knowledge and age; those that were older were better informed (p=0.008). The authors conclude that patient education and communication are essential for patients with ICDs to enhance decision-making about ICD management at the end of life.

The insertion of an implantable cardioverter defibrillator (ICD) is an established therapy for the prevention of sudden cardiac death (Epstein, 2008; Jackson and Murphy 2017). The first ICDs were implanted in the 1980s and since then the number of ICD implantations has risen steadily and will continue to rise (Fluur et al, 2013). An ICD has lifesaving capacity and provides physical and psychological ‘backup’ for a person who has sustained life-threatening cardiac dysrhythmias (Hill et al, 2016). Because of the immediacy of treatment provided by ICDs and the consequent prolongation of life, people who would have been susceptible to premature death now live longer. For many of these individuals, their natural end of life comes from a deterioration in their health or from illness (Resuscitation Council (UK) et al, 2015). The provision of a dignified death is important for all individuals, but specific considerations are warranted for those with ICDs.

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