{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:25:41Z","timestamp":1791329141282,"version":"4.3.1"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,1,31]],"date-time":"2014-01-31T00:00:00Z","timestamp":1391126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Link\u00ef\u00bf\u00bdping University Hospital Research Fund"},{"name":"Magnus Bergvalls Foundation"},{"name":"Medical Research Council of Southeast Sweden (FORSS)","award":["FORSS-306901"],"award-info":[{"award-number":["FORSS-306901"]}]},{"name":"the Swedish Heart- and Lung Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The current international expert consensus statements recommend that clinicians should discuss elective implantable cardioverter defibrillator (ICD) deactivation before implantation of the device, and then consistently during the illness trajectory. However, no previous studies have investigated predictors of ICD patients\u2019 knowledge about end\u2010of\u2010life issues or whether knowledge influences patients\u2019 attitudes about deactivation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This nationwide survey study (n = 3,067) had a cross\u2010sectional correlational design of self\u2010reported data. Participants were recruited from the Swedish ICD and Pacemaker Registry and asked to complete a questionnaire about knowledge in relation to the ICD and end\u2010of\u2010life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only 79 respondents (3%) scored correctly on all 11 questions. The mean sample score was 6.6 \u00b1 2.7 out of a maximum score of 11. A total of 835 participants (29%) had an insufficient knowledge when using the 25th percentile as a cutoff. Younger ICD recipients, those cohabiting, male participants, and those who had received shocks, had a generator replacement, or who had discussed illness trajectory with their physician were more likely to have sufficient knowledge on the end\u2010of\u2010life issues. Insufficient knowledge was associated with indecisiveness to make decisions about ICD deactivation in the end\u2010of\u2010life situations, and with favorable attitudes about replacing the ICD even if seriously ill or have reached an advanced age, and keeping the shock therapy of the ICD even in a terminal phase of life when dying from cancer or other serious chronic illnesses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Insufficient knowledge is common among ICD recipients and is associated with attitudes and decisions that may result in a stressful and potentially painful end\u2010of\u2010life situation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12353","type":"journal-article","created":{"date-parts":[[2014,1,31]],"date-time":"2014-01-31T19:25:03Z","timestamp":1391196303000},"page":"834-842","source":"Crossref","is-referenced-by-count":43,"title":["ICD Recipients\u2019 Understanding of Ethical Issues, ICD Function, and Practical Consequences of 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