Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Nov-Dec;55(3):290-9.
doi: 10.1016/j.pcad.2012.09.003.

Deactivation of pacemakers and implantable cardioverter-defibrillators

Daniel B Kramer  1 , Susan L Mitchell, Dan W Brock
Affiliations
Review

Deactivation of pacemakers and implantable cardioverter-defibrillators

Daniel B Kramer et al. Prog Cardiovasc Dis. 2012 Nov-Dec.

Abstract

Cardiac implantable electrical devices (CIEDs), including pacemakers (PMs) and implantable cardioverter-defibrillators (ICDs), are the most effective treatment for life-threatening arrhythmias. Patients or their surrogates may request device deactivation to avoid prolongation of the dying process or in other settings, such as after device-related complications or with changes in health care goals. Despite published guidelines outlining theoretical and practical aspects of this common clinical scenario, significant uncertainty remains for both patients and health care providers regarding the ethical and legal status of CIED deactivation. This review outlines the ethical and legal principles supporting CIED deactivation, centered upon patient autonomy and authority over their own medical treatment. The empirical literature describing stakeholder views and experiences surrounding CIED deactivation is described, along with implications of these studies for future research surrounding the care of patients with CIEDs.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Nietzsche FW, Kaufmann WA. The gay science; with a prelude in rhymes and an appendix of songs. 1. New York: Vintage Books; 1974.
    1. Hammill SC, Kremers MS, Stevenson LW, et al. Review of the registry’s fourth year, incorporating lead data and pediatric ICD procedures, and use as a national performance measure. Heart Rhythm. 2010 Sep;7(9):1340–1345. - PubMed
    1. Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 2008 May 27;117(21):e350–408. - PubMed
    1. Hlatky MA, Sanders GD, Owens DK. Evidence-based medicine and policy: the case of the implantable cardioverter defibrillator. Health Aff (Millwood) 2005 Jan-Feb;24(1):42–51. - PubMed
    1. Lamas GA, Lee KL, Sweeney MO, et al. Ventricular pacing or dual-chamber pacing for sinus-node dysfunction. N Engl J Med. 2002 Jun 13;346(24):1854–1862. - PubMed

Publication types

MeSH terms