ICD's near end of life: risk versus benefit- a review.
The number of annual implantable cardioverter defibrillator (ICD) implants has substantially increased over the last 5 years and is expected to grow rapidly. Implantable cardioverter defibrillators have a proven mortality benefit by terminating the life-threatening arrhythmias, even near end of life. In patients with moderate/severe symptomatic heart failure, enough clinical literature representing mortality benefits has been published, but limited numbers of studies have reviewed the dwindling risk-benefit profile near end of life, studying quality of life (QoL)/psychosocial impact. Criteria outlining either continued use or deactivation policy/procedures near end of life have not been clearly defined and/or largely implemented, which in turn requires more focused research using multifactorial approach to determine improved patient-centered outcomes.
Department of Internal Medicine, East Tennessee State University, TN 37604, USA. singhb@mail.etsu.edu
Balraj
B
Singh
Jasmeet
J
Singh
D001145:Arrhythmias, Cardiac / Q000628:therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000941:ethics; D006801:Humans; D011584:Psychology; D011788:Quality of Life; D018570:Risk Assessment; D013727:Terminal Care / Q000941:ethics