title: Implantable cardiac defibrillators and end-of-life care--time for reflection, deliberation and debate?
abstract: Heart failure (HF) is a common condition associated with high rates of morbidity and mortality. Implantable cardiac defibrillators (ICDs) are an important management strategy in HF management and decrease mortality for both primary and secondary prevention. An emerging body of literature identifies the challenges of managing ICDs at the end of life. This report discusses a critical incident experienced by a HF team in a referral centre and outlines the issues to be considered in advancing discussion and debate of managing ICDs at the end of life. Engaging in debate, discussion and consensus guidelines is likely to be crucial in minimising distress and burden for clinicians, patients and their families alike.
authors.affiliation: Cardiac Rehabilitation Service, Fairfield Hospital, and Curtin University of Technology, Centre for Cardiovascular and Chronic Care, Chippendale, NSW, Australia. Maria.SHEEHAN@sswahs.nsw.gov.au
authors.forename: Maria
authors.initials: M
authors.lastname: Sheehan
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Newton
authors.forename: Paul
authors.initials: P
authors.lastname: Stobie
authors.forename: Patricia Mary
authors.initials: PM
authors.lastname: Davidson
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D017809:Fatal Outcome; D006333:Heart Failure / Q000451:nursing / Q000628:therapy*; D006801:Humans; D008297:Male; D013727:Terminal Care / Q000941:ethics* / Q000331:legislation & jurisprudence*