{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T11:10:02Z","timestamp":1756206602271,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Support Palliat Care"],"accepted":{"date-parts":[[2024,12,4]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>Implantable cardioverter defibrillators (ICDs) are implanted in increasing numbers of patients with the aim of treating ventricular arrhythmias in high-risk patients and reducing their risk of dying. Individuals are also living longer with these devices. As a result, a greater number of patients with an ICD will deteriorate either with worsening cardiac failure, another non-cardiac condition or general frailty and will have a limited prognosis. Frequently they will be cared for by non-cardiac teams who may be less familiar with ICDs. Therefore, to ensure the person receives high-quality end-of-life care, they should have the opportunity to consider and discuss the option to deactivate the shock function of their ICD. If the ICD shock therapy is not discontinued, there is an increased risk that as a person reaches the last days of life, the ICD may deliver painful shocks which are distressing. There is also a risk that the device may delay the person\u2019s natural death which the person would not have chosen if they had been given the opportunity to discuss discontinuation. The British Heart Rhythm Society has developed a practical document to support all healthcare professionals who are caring for patients who have an ICD. This includes descriptions of different device types, ethical and legal aspects, timing and nature of ICD discussions and practical advice regarding how the devices may be deactivated. It aims to promote awareness and timely discussion between professionals and patients and to encourage best practice.<\/jats:p>","DOI":"10.1136\/spcare-2024-005233","type":"journal-article","created":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T06:45:10Z","timestamp":1735368310000},"page":"184-190","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Implantable cardioverter defibrillator deactivation and end-of-life: British Heart Rhythm Society practical consensus guideline"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4011-8858","authenticated-orcid":false,"given":"Honey","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Cardiology, Northumbria Healthcare NHS Foundation Trust, North Shields, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Wallace","sequence":"additional","affiliation":[{"name":"Care of the Elderly, Northumbria Healthcare NHS Foundation Trust, North Shields , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Foley","sequence":"additional","affiliation":[{"name":"Great Western Hospitals NHS Foundation Trust, Swindon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6204-9158","authenticated-orcid":false,"given":"Miriam J","family":"Johnson","sequence":"additional","affiliation":[{"name":"Wolfson Palliative Care Research Centre, University of Hull, Hull, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"2025082603501634000_15.2.184.1","unstructured":"Deactivation of implantable cardioverter-defibrillators towards the end of life: a guide for healthcare professionals from the Resuscitation Council UK the British Cardiovascular Society and the National Council for Palliative Care. n.d. Available: https:\/\/www.resus.org.uk\/sites\/default\/files\/2020-05\/cieds%20deactivation.pdf"},{"key":"2025082603501634000_15.2.184.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002648"},{"key":"2025082603501634000_15.2.184.3","unstructured":"Deactivating the shock function of an implantable cardioverter defibrillator (ICD) towards the end of life: a guide for patients and carers. n.d. Available: https:\/\/www.resus.org.uk\/sites\/default\/files\/2020-05\/CIEDs%20leaflet_patients.pdf"},{"key":"2025082603501634000_15.2.184.4","unstructured":"A decision aid for implantable cardioverter defibrillators (ICDs): for patients with heart failure considering an ICD who are at risk of sudden cardiac death (primary prevention). n.d. Available: https:\/\/bhrs.com\/wp-content\/uploads\/2023\/11\/ICD-Infographic-FINAL-2018-UK.pdf"},{"key":"2025082603501634000_15.2.184.5","first-page":"757","article-title":"Frailty Status Modifies the Efficacy of ICD Therapy for Primary Prevention Among Patients With HF","volume":"12","author":"Segar","year":"2024","journal-title":"JACC HF"},{"key":"2025082603501634000_15.2.184.6","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.123.012309","article-title":"Implantable Cardioverter-defibrillator Deactivation at Distance for the Dignity of Dying (the 4D Project)","volume":"16","author":"Alexander","year":"2023","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["BMJ Supportive &amp; Palliative Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/spcare-2024-005233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T10:50:31Z","timestamp":1756205431000},"score":1,"resource":{"primary":{"URL":"https:\/\/spcare.bmj.com\/lookup\/doi\/10.1136\/spcare-2024-005233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,27]]},"references-count":6,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,26]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/spcare-2024-005233"],"URL":"https:\/\/doi.org\/10.1136\/spcare-2024-005233","relation":{},"ISSN":["2045-435X","2045-4368"],"issn-type":[{"type":"print","value":"2045-435X"},{"type":"electronic","value":"2045-4368"}],"subject":[],"published":{"date-parts":[[2024,12,27]]}}}