scholarly journals Unmet device reprogramming needs at the end of life among patients with implantable cardioverter defibrillator: A systematic review and meta-analysis

2020 ◽  
Vol 34 (8) ◽  
pp. 1019-1029
Author(s):  
Valentina Gonzalez-Jaramillo ◽  
Piotr Sobanski ◽  
Jose A Calvache ◽  
Luisa F Arenas-Ochoa ◽  
Oscar H Franco ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Advance Directives ◽  
Bibliographic Databases ◽  
Cochrane Central Register ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillator ◽  
Logit Transformation ◽  
Pooled Prevalence

Background: Use of implantable cardioverter defibrillators is increasingly common. As patients approach the end of life, it is appropriate to deactivate the shock function. Aim: To assess the prevalence of implantable cardioverter defibrillator reprogramming to deactivate the shock function at the end of life and the prevalence of advance directives among this population. Design: Following a previously established protocol available in PROSPERO, we performed a narrative synthesis of our findings and used the logit transformation method to perform our quantitative synthesis. Data sources: We searched seven bibliographic databases (Embase, Cochrane Central register of controlled Trials, Medline-Ovid, Web-of-Science, Scopus, PsychInfo, and CINAHL) and additional sources until April 2019. Results: Of the references we identified, 14 were included. We found a pooled prevalence of implantable cardioverter defibrillator reprogramming at the end of life of 28% (95% confidence interval, 22%–36%) with higher reprogramming rates after the recommendations for managing the device at the end of life were published. Among patients with advance directives, the pooled prevalence of advance directives that explicitly mentioned the device was 1% (95% confidence interval, 1%–3%). Conclusions: The prevalence of implantable cardioverter defibrillator reprogramming and advance directives that explicitly mentioned the device was very low. Study data suggested reprogramming decisions were made very late, after the patient experienced multiple shocks. Patient suffering could be ameliorated if physicians and other healthcare professionals adhere to clinical guidelines for the good management of the device at the end of life and include deactivating the shock function in the discussion that leads to the advance directive.

scholarly journals Implantable cardioverter defibrillator knowledge and end-of-life device deactivation: A cross-sectional survey

2017 ◽  
Vol 32 (1) ◽  
pp. 156-163 ◽  
Author(s):  
Samantha M McEvedy ◽  
Jan Cameron ◽  
Eugene Lugg ◽  
Jennifer Miller ◽  
Chris Haedtke ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Interdisciplinary Approach ◽  
The United States ◽  
Implantable Cardioverter Defibrillators ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cardioverter Defibrillator

Background: End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients’ last days. Aim: To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. Design: Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire. Participants were classified as insufficient or sufficient implantable cardioverter defibrillator knowledge and the two groups were compared. Setting/participants: Implantable cardioverter defibrillator recipients ( n = 270, mean age 61 ± 14 years; 73% male) were recruited from cardiology and implantable cardioverter defibrillator clinics attached to two tertiary hospitals in Melbourne, Australia, and two in Kentucky, the United States. Results: Participants with insufficient implantable cardioverter defibrillator knowledge ( n = 77, 29%) were significantly older (mean age 66 vs 60 years, p = 0.001), less likely to be Caucasian (77% vs 87%, p  = 0.047), less likely to have received implantable cardioverter defibrillator shocks (26% vs 40%, p = 0.031), and more likely to have indications of mild cognitive impairment (Montreal Cognitive Assessment score <24: 44% vs 16%, p < 0.001). Insufficient implantable cardioverter defibrillator knowledge was associated with attitudes suggesting unwillingness to discuss implantable cardioverter defibrillator deactivation, even during the last days towards end of life ( p < 0.05). Conclusion: Implantable cardioverter defibrillator recipients, especially those who are older or have mild cognitive impairment, often have limited knowledge about implantable cardioverter defibrillator deactivation. This study identified several potential teachable moments throughout the patients’ treatment trajectory. An interdisciplinary approach is required to ensure that discussions about implantable cardioverter defibrillator deactivation issues are initiated at appropriate time points, with family members ideally also included.

scholarly journals Electromagnetic Interference with Implantable Cardioverter Defibrillators Causing Inadvertent Shock: Case Report and Review of Current Literature

2014 ◽  
Vol 8 ◽  
pp. CMC.S10990 ◽  
Author(s):  
Muhammad Akhtar ◽  
Tariq Bhat ◽  
Mohmad Tantray ◽  
Chris Lafferty ◽  
Saiful Faisal ◽  
...  
Keyword(s):  
Case Report ◽  
Implantable Cardioverter Defibrillator ◽  
Current Literature ◽  
Electromagnetic Interference ◽  
Interesting Case ◽  
Implantable Cardioverter Defibrillators ◽  
Normal Functioning ◽  
Cardioverter Defibrillator ◽  
Number Of Patients ◽  
Cardioverter Defibrillators

As the number of patients having implantable cardioverter defibrillator (ICD) devices is increasing, it is important for the physicians and patients to be aware of situations and conditions that can result in interference with normal functioning of these devices. There are multiple cases of malfunction of ICDs reported in literature and it may be of great significance to have an overview of these incidents for appropriate recognition and future prevention. Here we are reviewing the available literature as well as reporting an interesting case of electromagnetic interference (EMI) resulting from leak of current in pool water causing firing of ICD.

Patients' Perspective on Deactivation of the Implantable Cardioverter-Defibrillator Near the End of Life

2013 ◽  
Vol 111 (10) ◽  
pp. 1443-1447 ◽  
Author(s):  
Susanne S. Pedersen ◽  
Rismy Chaitsing ◽  
Tamas Szili-Torok ◽  
Luc Jordaens ◽  
Dominic A.M.J. Theuns
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Cardioverter Defibrillator ◽  
Patients Perspective

Treatment of phantom shocks: A case report

2018 ◽  
Vol 54 (3) ◽  
pp. 181-187
Author(s):  
Danielle R Hairston ◽  
Ralph H de Similien ◽  
Seth Himelhoch ◽  
Anique Forrester
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Preventive Treatment ◽  
Adverse Outcomes ◽  
Implantable Cardioverter Defibrillators ◽  
Psychological Consequences ◽  
Cardioverter Defibrillator ◽  
Objective Evidence ◽  
Patient Reported ◽  
Life Threatening ◽  
Chronic Anxiety

Implantable cardioverter-defibrillators have become standard preventive treatment for patients with ventricular arrhythmias and other life-threatening cardiac conditions. The advantages and efficiency of the device are supported by multiple clinical trials and outcome studies, leading to its popularity among cardiologists. Implantation of the device is not without adverse outcomes. Implantable cardioverter-defibrillator placement has been found to lead to negative psychological and psychosocial sequelae such as apprehension to engage in physical activity, chronic anxiety, decreased physical and social functioning, a nagging fear of being shocked by the device, and the development of “phantom shocks.” Defined as patient-reported shocks in the absence of evidence that the implantable cardioverter-defibrillator device has discharged, phantom shocks could impact the mental health of those affected. This article reviews the case of Mr. L, a 47-year-old man with ischemic cardiomyopathy who was seen by the psychiatry consultation team while under cardiologic care because he reported that his implantable cardioverter-defibrillator device had been shocking him despite no objective evidence after interrogating the device. A literature review of phantom shocks, their associated symptomatology, and psychological consequences are outlined and discussed.

scholarly journals 176-55: Implantable Cardioverter Defibrillator Patients Remain at Risk of Painful Shocks at the End of Life

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i131-i131
Author(s):  
Dilek Yilmaz ◽  
Aafke Van Der Heijden ◽  
Joep Thijssen ◽  
Martin Schalij ◽  
Lieselot van Erven
Keyword(s):  
At Risk ◽  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Cardioverter Defibrillator

Normativity under change

2015 ◽  
Vol 23 (3) ◽  
pp. 328-338 ◽  
Author(s):  
Jette Rolf Svanholm ◽  
Jens Cosedis Nielsen ◽  
Peter Thomas Mortensen ◽  
Charlotte Fuglesang Christensen ◽  
Regner Birkelund
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Political Ideology ◽  
Older Persons ◽  
Empirical Studies ◽  
Modern Society ◽  
Cardioverter Defibrillator ◽  
Life Issues ◽  
End Of Life Issues ◽  
Critical Interpretation

Background: In modern society, death has become ‘forbidden’ fed by the medical technology to conquer death. The technological paradigm is challenged by a social-liberal political ideology in postmodern Western societies. The question raised in this study was as follows: Which arguments, attitudes, values and paradoxes between modern and postmodern tendencies concerning treatment and care of older persons with an implantable cardioverter defibrillator appear in the literature? Aims: The aim of this study was to describe and interpret how the field of tension concerning older persons with an implantable cardioverter defibrillator – especially end-of-life issues – has been expressed in the literature throughout the last decade. Methods: Paul Ricoeur’s reflexive interpretive approach was used to extract the meaningful content of the literature involving qualitative, quantitative and normative literature. Analysis and interpretation involved naive reading, structural analysis and critical interpretation. Ethical considerations: The investigation complied with the principles outlined in the Declaration of Helsinki. Findings and discussions: The unifying theme was ‘Normativity under change’. The sub-themes were ‘Death has become legitimate’, ‘The technological imperative is challenged’ and ‘Patients and healthcare professionals need to talk about end-of-life issues’. There seems to be a considerable distance between the normative approach of how practice ought to be and findings in empirical studies. Conclusion: Modern as well as postmodern attitudes and perceptions illustrate contradictory tendencies regarding deactivation of the implantable cardioverter defibrillator and replacement of the implantable cardioverter defibrillator in older persons nearing the end of life. The tendencies challenge each other in a struggle to gain position. On the other hand, they can also complement each other because professionalism and health professional expertise cannot stand alone when the patient’s life is at stake but must be unfolded in an alliance with the patient who needs to be understood and accepted in his vulnerability.

Cardiac Pacemakers at End of Life #111; Implantable Cardioverter Defibrillator (ICD) at End of Life #112

2005 ◽  
Vol 8 (5) ◽  
pp. 1055-1057 ◽  
Author(s):  
M.D. Harrington ◽  
D.L. Luebke ◽  
W.R. Lewis ◽  
M.P. Aulisio ◽  
N.J. Johnson
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
End Of Life ◽  
Cardiac Pacemakers ◽  
Cardioverter Defibrillator
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