title: Patients' experiences of the implantable cardioverter defibrillator (ICD); with a focus on battery replacement and end-of-life issues.
abstract: BACKGROUND
  ICD deactivation at end-of-life is technically uncomplicated. However, it may present a psychological challenge to healthcare professionals, patients, and next-of-kin.
  
  
  OBJECTIVE
  This study explored patients' experiences of complex issues of battery replacement and deactivation of the ICD.
  
  
  METHODS
  Semistructured interviews were administered to 37 medically stable ICD-recipients.
  
  
  RESULTS
  The ICD-recipients lived with an uncertain illness trajectory, but the majority had not reflected on battery replacement or elective ICD deactivation. Healthcare professionals had rarely discussed these issues with patients. However, this was consistent with the ICD-recipients' wishes. Many patients had misconceptions about the lifesaving capacity of the ICD and the majority stated that they would not choose to deactivate the ICD, even if they knew they were terminally ill, and it meant they would receive multiple shocks.
  
  
  CONCLUSIONS
  The ICD-recipients tended not to think about end-of-life issues, which imply that many patients reach the final stages of life unaware of the option of ICD deactivation.
authors.affiliation: Department of Cardiology UHL, County Council of Östergötland, Linköping, Sweden. christina.fluur@lio.se
authors.forename: Christina
authors.initials: C
authors.lastname: Fluur
authors.forename: Kärstin
authors.initials: K
authors.lastname: Bolse
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.forename: Ingela
authors.initials: I
authors.lastname: Thylén
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013727:Terminal Care / Q000523:psychology*