Implantable cardioverter defibrillator: decision-making on turning off in patients with end-stage heart failure
https://doi.org/10.15829/1560-4071-2020-3868
Abstract
The use of implantable cardioverter defibrillators has become a common standard method of primary and secondary prevention of sudden cardiac death, prolonging the life of patients with cardiomyopathy. At the same time, with the disease and comorbidity progression, at the final stages of life, a difficult decision arises to turn off the device due to a shift in priorities from extending life to maintaining its quality. Heart failure patients eventually die due to the progression of the underlying disease, despite currently available advanced technologies. Whether certain lifesustaining treatment methods are still appropriate in the final stages of life is an important topic of discussion in this article. Palliation for patients with implantable cardioverter-defibrillators is a challenging issue for both patients and medical professionals. This article describes the different ways to turn off defibrillation devices based on patient status.
About the Authors
V. K. Lebedeva
Almazov National Medical Research Center
Russian Federation
St. Petersburg.
Competing Interests: Конфликт интересов не заявляется
Russian Federation
St. Petersburg.
Competing Interests: Конфликт интересов не заявляется
D. S. Lebedev
Almazov National Medical Research Center
Russian Federation
Competing Interests: конфликт интересов не заявляется
Russian Federation
St. Petersburg.
Competing Interests: конфликт интересов не заявляется
References
1. Priori SG, Blomstrom-Lundqvist C, Mazzanti A, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Eur Heart J. 2015;36:2793-867. doi:10.1093/eurheartj/ehv316.
2. Thylen I, Moser DK, Stromberg A, et al. Concerns about implantable cardioverterdefibrillator shocks mediate the relationship between actual shocks and psychological distress. Europace. 2016;18:828-35. doi:10.1093/europace/euv220.
3. Bardy GH, Lee KL, Mark DB, et al, for the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J. Med. 2005;352(3):225-37. doi:10.1056/nejmoa043399.
4. Mareev VYu, Fomin IV, Ageev FT, et al. Clinical recommendations. Chronic heart failure Journal Of Heart Failure. 2017;18(1):3-40. (In Russ.) doi:10.18087/rhfj.2017.1.2346.
5. Cleland JGF, Hindricks G, Petrie M. The shocking lack of evidence for implantable cardioverter defibrillators for heart failure; with or without cardiac resynchronization. Eur Heart J. 2019;40:2128-30. doi:10.1093/eurheartj/ehz409.
6. Padeletti L, Arnar DO, Boncinelli L, et al. EHRA expert consensus statement on the management of cardiovascular implantable electronic devices in patients nearing end of life or requesting withdrawal of therapy. Europace. 2010;12:1480-9. doi:10.1093/europace/euq275.
7. Greenberg H, Case RB, Moss AJ, et al. Analysis of mortality events in the multicenter automatic defibrillator implantation trial (MADIT-II). JACC. 2004;43(8):1459-65. doi:10.1016/j.jacc.2003.11.038.
8. Fromme EK, Lugliani Stewart T, et al. Adverse experiences with implantable defibrillators in Oregon Hospices. Am Hosp Hosp Palliat Care. 2011;28:304-9. doi:10.1177/1049909110390505.
9. Cubbon RM, Gale CP, Kearney LC, et al. Changing characteristics and mode of death associated with chronic heart failure caused by left ventricular systolic dysfunction: a study across therapeutic eras. Circ Heart Fail. 2011;4:396-403. doi:10.1161/circheartfailure.110.959882.
10. Nazarian S, Maisel WH, Miles JS, et al. Impact of implantable cardioverter defibrillators on survival and recurrent hospitalization in advanced heart failure. Am Heart J. 2005;150:955-60. doi:10/1016/j.ahj.2005.01.012.
11. Goldenberg I, Huang DT, Nielsen JC. The role of implantable cardioverter-defibrillators and sudden cardiac death prevention: indications, device selection, and outcome. Eur Heart J. 2019:ehz788. doi:10.1093/eurheartj/ehz788.
12. Goldstein N, Carlson M, Livote E, et al. Brief communication: management of implantable cardioverter-defibrillators in hospice: a nationwide survey. Ann Intern Med. 2010;152(5):296-9. doi:10.7326/0003-4819-152-5-201003020-00007.
13. Allen LA, Stevenson LW, Grady KL, et al. Decision Making in Advanced Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2012;125(15):1928-52. doi:10.1161/CIR.0b013e31824f2173.
14. Stewart GC, Weintraub JR, Pratibhu PP, et al. Patient expectations from implantable defibrillators to prevent death in heart failure. J Card Fail. 2010;16(2):106-13. doi:10.1016/j.cardfail.2009.09.003.
15. Clark AM, Jaarsma T, Strachan P, et al. Effective communication and ethical consent in decisions related to ICDs. Nat Rev Cardiol. 2011;8:694-705. doi:10.1038/nrcardio.2011.101.
Review
For citations:
Lebedeva V.K., Lebedev D.S. Implantable cardioverter defibrillator: decision-making on turning off in patients with end-stage heart failure. Russian Journal of Cardiology. 2020;25(9):3868. https://doi.org/10.15829/1560-4071-2020-3868
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