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
. 2023 Nov 3;11(21):2896.
doi: 10.3390/healthcare11212896.

Patients' Perspective on Termination of Pacemaker Therapy-A Cross-Sectional Anonymous Survey among Patients Carrying a Pacemaker in Germany

Irene Portig  1 , Elif Karaaslan  1 , Elena Hofacker  1 , Christian Volberg  1 , Carola Seifart  1
Affiliations

Patients' Perspective on Termination of Pacemaker Therapy-A Cross-Sectional Anonymous Survey among Patients Carrying a Pacemaker in Germany

Irene Portig et al. Healthcare (Basel). .

Abstract

Objective: To determine the opinions of patients regarding the withdrawal of pacemaker therapy.

Participants and methods: A cross-sectional anonymous questionnaire was administered to patients visiting an outpatient cardiologic clinic for routine follow-up visits of pacemaker therapy or patients carrying a pacemaker admitted to a hospital between 2021 and 2022.

Results: Three-hundred and forty patients answered the questionnaire. A total of 56% of the participants were male. The mean age was 81 years. The majority of respondents were very comfortable with their PM and felt well informed, with one exception: more than half of respondents were missing information on withdrawal of pacemaker therapy. Almost two-thirds wanted to decide for themselves if their pacemaker therapy was withdrawn regardless of whether they were ill or healthy. Almost 60% of patients would like the pacemaker to be turned off when dying. Women expressed this wish significantly more often than men.

Conclusion: Our survey shows that patients prefer to be informed on issues regarding the withdrawal of pacemakers as early as preimplantation. Also, patients would like to be involved in decisions that have to be made at the end of life, including decisions on withdrawal. Offers of conversations about this important issue should include information on special features of the patient's pacemaker, e.g., the absence or presence of pacemaker dependency. Knowledge about the pacemaker's functionality may prevent distress among individuals nearing their end of life when, for example, under the false impression that timely deactivation may allow for a more peaceful death.

Keywords: autonomy; end-of-life care; pacemaker; patients’ perspective.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflict of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1
Figure 1
Patients’ attitudes toward PM therapy.
Figure 2
Figure 2
Patients’ desire for more information regarding their PM (* p < 0.05).
Figure 3
Figure 3
Patients’ desire for PM withdrawal at the end of life (* p < 0.05).
Figure 4
Figure 4
Patients’ desire for an autonomous decision regarding PM withdrawal (* p < 0.05).
See this image and copyright information in PMC

References

    1. Markewitz A., Nowak B., Fröhlig G., Lemke B., Wiegand U., Kolb C., Burger H. Jahresbericht 2020 des Deutschen Herzschrittmacher- und Defibrillator-Registers–Teil 1: Herzschrittmacher. Herzschrittmacherther. Elektrophysiol. 2022;33:398–413. doi: 10.1007/s00399-022-00893-5. - DOI - PubMed
    1. Glikson M., Nielsen J.C., Kronborg M.B., Michowitz Y., Auricchio A., Barbash I.M., Barrabés J.A., Boriani G., Braunschweig F., Brignole M., et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur. Heart J. 2021;42:3427–3520. doi: 10.1093/eurheartj/ehab364. - DOI - PubMed
    1. Kusumoto F.M., Schoenfeld M.H., Barrett C., Edgerton J.R., Ellenbogen K.A., Gold M.R., Goldschlager N.F., Hamilton R.M., Joglar J.A., Kim R.J., et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay. J. Am. Coll. Cardiol. 2019;74:e51–e156. doi: 10.1016/j.jacc.2018.10.044. - DOI - PubMed
    1. Andersen H.R., Nielsen J.C., Thomsen P.E.B., Thuesen L., Mortensen P.T., Vesterlund T., Pedersen A.K. Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome. Lancet. 1997;350:1210–1216. doi: 10.1016/S0140-6736(97)03425-9. - DOI - PubMed
    1. Lamas G.A., Orav E.J., Stambler B.S., Ellenbogen K.A., Sgarbossa E.B., Huang S.K., Marinchak R.A., Estes N.A., 3rd, Mitchell G.F., Lieberman E.H., et al. Quality of life and clinical outcomes in elderly patients treated with ventricular pacing as compared with dual-chamber pacing. Pacemaker Selection in the Elderly Investigators. N. Engl. J. Med. 1998;338:1097–1104. doi: 10.1056/NEJM199804163381602. - DOI - PubMed

LinkOut - more resources