ICDs in end-stage heart failure

Pettit, S., Browne, S. , Hogg, K.J., Connelly, D.T., Gardner, R.S., May, C.R., Macleod, U. and Mair, F.S. (2012) ICDs in end-stage heart failure. BMJ Supportive and Palliative Care, 2, pp. 94-97. (doi:10.1136/bmjspcare-2011-000176)

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Publisher's URL: http://spcare.bmj.com/content/2/2/94

Abstract

Implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients with chronic heart failure but prognostic benefit is likely to attenuate with progression to end-stage heart failure. The incidence of multiple futile ICD shocks before death is uncertain. Only individual patients, supported by their healthcare professionals, can decide when ICD therapy becomes futile in end-stage heart failure. Despite consensus that ICD deactivation should be routinely discussed, this rarely occurs in clinical practice for many reasons including uncertainty about when to initiate these discussions and reluctance to confront death and dying. Patient and carer opinions about end-stage heart failure and ICD deactivation may not meet professional expectations. Future research should focus on these opinions and examine interventions that bridge the gap between best practice and the reality of current clinical practice.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gardner, Dr Roy and Mair, Professor Frances and Browne, Dr Susan
Authors: Pettit, S., Browne, S., Hogg, K.J., Connelly, D.T., Gardner, R.S., May, C.R., Macleod, U., and Mair, F.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:BMJ Supportive and Palliative Care
ISSN:2045-435X
ISSN (Online):2045-4368

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