Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author’s findings, recommendations for discussing and implementing ICD deactivation are offered. Health care organizations should have clear policies addressing ICD deactivation to provide for seamless integration of palliative care services throughout the course of heart failure. These policies should empower nurses to activate resources in a timely manner and should clearly outline processes for ICD deactivation.
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Feature| December 01 2016
Planning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure
Destiny R. Brady, RN, MSN, CCRN
Destiny R. Brady teaches critical care nursing at Saint Anselm College in Manchester, New Hampshire.
Corresponding author: Destiny Rachel Brady, rn, msn, ccrn, Clinical Nursing Faculty, Saint Anselm College, 100 Saint Anselm Dr, Box 1745, Manchester, NH 03102 (e-mail: firstname.lastname@example.org).
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Crit Care Nurse (2016) 36 (6): 24–31.
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Destiny R. Brady; Planning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure. Crit Care Nurse 1 December 2016; 36 (6): 24–31. doi: https://doi.org/10.4037/ccn2016362
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