ReviewDeutsches Arzteblatt international2012
The deactivation of implantable cardioverter-defibrillators: medical, ethical, practical, and legal considerations.
Review in Deutsches Arzteblatt international, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 21 citations in OpenAlex.
- Multifaceted aspects of charge transfer.Physical chemistry chemical physics : PCCP · 2020Article
- [Choosing wisely at the end of life : Recommendations of the German Society for Palliative Medicine (DGP)].Der Internist · 2017Review
- [Ethics in intensive care and euthanasia : With respect to inactivating defibrillators at the end of life in terminally ill patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2017Review
- Ethical challenges of deactivation of cardiac devices in advanced heart failure.Current heart failure reports · 2014Review
- [Dying with/despite a pacemaker].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Article
- [The chronic critically ill patient from the cardiologist's perspective].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImplantable cardioverter-defibrillators (ICDs) cannot prevent death from progressive heart failure or non-cardiac disease. Patients with ICDs may receive defibrillation therapy from their devices in the last days of their lives, when such therapy does not accord with the goal of palliative treatment, but rather lowers these patients' quality of life and compromises their dignity.
methodsWe present a case report and a selective review of pertinent literature retrieved by a PubMed search, including two up-to-date consensus documents.
resultsOne-third to two-thirds of all ICD patients receive defibrillation therapy in the final days of their lives. Patients and their physicians rarely discuss deactivating the ICD. The ethical aspects of such decisions need to be considered. As a practical matter, it is possible to deactivate certain types of electrotherapy selectively, while leaving others active. There are logistical considerations as well.
conclusionAutomatic defibrillation therapy in a terminally ill patient with an ICD is painful and distressing, serves no medical purpose, and should be avoided. This issue should be discussed with ICD patients and their families. Institutions caring for terminally ill patients, as well as cardiology units where ICD patients are treated, should develop ethically and legally well-founded protocols for dealing with the question of ICD deactivation.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.