DEACTIVATION OF IMPLANTABLE CARDIAC DEVICES IN END-STAGE HEART FAILURE PATIENTS
Pagona Metou
Saturday, July 1, 2023
Publication year:
2023
Author:
- Metou Pagona, ΜSc in “Applied Clinical Nursing. Nursing” in specialization “Pathological Nursing” University of West Attica, Athens, Greece
Keywords index:
Pages: 239-246
Abstract:
Introduction: Implantation of cardiac devices in patients with heart failure has contributed to improvement in quality
of their life. Nevertheless, in the final stages of the disease, it is necessary to deactivate the devices for a peaceful death
and the avoidance of suffering.The purpose of this review was to explore deactivation of implantable cardiac devices
in end-stage heart failure patients.Methodology: A literature review was conducted of studies published from 2010 to
2023 in the online databases PubMed and Google Scholar. The following keywords were used in the search: "pacemaker",
"defibrillator", "terminal patients", "deactivation" and "heart failure".Results: According to the literature, deactivation
of implantable cardiac devices in end-stage patients is rarely performed and is less feasible in patients with
pacemakers. The universal guidelines of Cardiology emphasize that patients should be involved in the decision-making
process, be aware of the possible complications related to implantation, and be informed of deactivation (e.g. terminal
illness). Discussions about device deactivation should provide a broader understanding of the chronicity and course of
the disease, the burden on patients and their families, and mortality. In terms of gender, men are more reluctant to
discuss deactivation through advanced care planning. Healthcare professionals ought to ensure that patients understand
the reasons for deactivation recommendations, be able to address patients' fears, and understand decisions for or
against the proposed treatment.Conclusions: Healthcare professionals' knowledge about implantable cardiac device
deactivation needs improvements in order to to bridge the gap between guidelines and clinical practice.
