{"id":1577,"date":"2014-04-13T15:29:23","date_gmt":"2014-04-13T14:29:23","guid":{"rendered":"https:\/\/blogs.bmj.com\/heart-journalscan\/?p=1577"},"modified":"2015-11-12T16:48:08","modified_gmt":"2015-11-12T15:48:08","slug":"cardiac-device-deactivation-rarely-mentioned-in-advanced-directives","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/heart\/2014\/04\/13\/cardiac-device-deactivation-rarely-mentioned-in-advanced-directives\/","title":{"rendered":"Cardiac device deactivation rarely mentioned in advanced directives"},"content":{"rendered":"<p><span style=\"line-height: 1.5em\">The authors retrospectively reviewed medical records of 150 patients who underwent deactivation of a pacemaker or implantable cardioverter-defibrillator in a four-year period at a single tertiary care center. These were older patients (median age 79) and 99% had a poor or terminal prognosis. More than half of the patients had an advance directive, yet only 1 patient explicitly mentioned device deactivation in their advanced directive. Surrogates for the patient made more than half of the requests for device deactivation (51%). Median survival after device deactivation was 2 days (IQR 0-483).<\/span><!--more--><\/p>\n<p><b>Conclusion<\/b><\/p>\n<p>The intersection of implantable cardiac devices and end-of-life care is certain to become more frequent.\u00a0 The current study highlights an important gap in addressing these devices as part of advance directives and end-of-life planning, leaving surrogates frequently burdened with the decision of device deactivation.<\/p>\n<p>Summarized by Steven M. Bradley and Supriya Shore<\/p>\n<ul>\n<li>Buchhalter LC, Ottenberg AL, Webster TL, et al. Features and outcomes of patients who underwent cardiac device deactivation. JAMA Intern Med. 2014 Jan;174(1):80-5.<\/li>\n<\/ul>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The authors retrospectively reviewed medical records of 150 patients who underwent deactivation of a pacemaker or implantable cardioverter-defibrillator in a four-year period at a single tertiary care center. These were older patients (median age 79) and 99% had a poor or terminal prognosis. More than half of the patients had an advance directive, yet only [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/heart\/2014\/04\/13\/cardiac-device-deactivation-rarely-mentioned-in-advanced-directives\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":47,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[279],"tags":[2873],"class_list":["post-1577","post","type-post","status-publish","format-standard","hentry","category-general-cardiology","tag-defibrillator"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cardiac device deactivation rarely mentioned in advanced directives - Heart<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/heart\/2014\/04\/13\/cardiac-device-deactivation-rarely-mentioned-in-advanced-directives\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cardiac device deactivation rarely mentioned in advanced directives - Heart\" \/>\n<meta property=\"og:description\" content=\"The authors retrospectively reviewed medical records of 150 patients who underwent deactivation of a pacemaker or implantable cardioverter-defibrillator in a four-year period at a single tertiary care center. 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