ArticleEuropean journal of cardiovascular nursing2019
Trends in time in the management of the implantable cardioverter defibrillator in the last phase of life: a retrospective study of medical records.
Article in European journal of cardiovascular nursing, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- The difficult discussion on the deactivation of implantable cardioverter devices at the end of life: a systematic review.ESC heart failure · 2025Pooled it
- Unmet device reprogramming needs at the end of life among patients with implantable cardioverter defibrillator: A systematic review and meta-analysis.Palliative medicine · 2020Pooled it
- Shifting paradigms in ICD tachytherapy deactivation in the final phase of life: eighteen years of perspective.European heart journal. Quality of care & clinical outcomes · 2026Article
- Palliative and End-of-Life Care During Critical Cardiovascular Illness: A Scientific Statement From the American Heart Association.Circulation · 2025Review
- Defibrillati|on|off.JACC. Case reports · 2025Article
- Article
- Expanding the Paradigm for Cardiovascular Palliative Care.Circulation · 2023Review
- Advance care planning and end-of-life care in patients with an implantable cardioverter defibrillator: The perspective of relatives.Palliative medicine · 2021Article
- Palliative Care in Acute Heart Failure.Current heart failure reports · 2020Review
- Implantable cardioverter defibrillators at the end of life: future perspectives on clinical practice.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Review
- Implantable cardioverter defibrillator deactivation and advance care planning: a focus group study.Heart (British Cardiac Society) · 2020Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe implantable cardioverter defibrillator (ICD) might give unwanted shocks in the last month of life. Guidelines recommend deactivation of the ICD prior to death.
aimsThe aims of this study were to examine trends in time (2007-2016) in how and when decisions are made about ICD deactivation, and to examine patient- and disease-related factors which may have influenced these decisions. In addition, care and ICD shock frequency in the last month of life of ICD patients are described.
methodsMedical records of a sample of deceased patients who had their ICD implanted in 1999-2015 in a Dutch university (
resultsMedian age at death was 71 years, and 88% were male. ICD deactivation discussions increased from 6% for patients who had died between 2007 and 2009 to 35% for patients who had died between 2013 and 2016. ICD deactivation rates increased in these periods from 16% to 42%. Presence of do-not-resuscitate (DNR) orders increased from 9% to 46%. Palliative care consultations increased from 0% to 9%. When the ICD remained active, shocks were reported for 7% of patients in the last month of life. Predictors of ICD deactivation were the occurrence of ICD deactivation discussions after implantation (OR 69.30, CI 26.45-181.59), DNR order (OR 6.83, CI 4.19-11.12), do-not-intubate order (OR 6.41, CI 3.75-10.96), and palliative care consultations (OR 8.67, CI 2.76-27.21).
conclusionICD deactivation discussions and deactivation rates have increased since 2007. Nevertheless, ICDs remain active in the majority of patients at the end of life, some of whom experience shocks.
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