What considerations should healthcare professionals take into account when discussing the deactivation of ICDs with patients?
Healthcare professionals should consider discussing with the person their goals of ongoing treatment and whether the ICD remains in line with those goals, as part of general advanced care planning. This may be appropriate where the symptoms of a person with heart failure have deteriorated over a period of time despite optimal treatment, people whose care goals are changing, in very elderly people, and with people thought to be nearing the end of their life. All health care professionals caring for patients with heart failure should be prepared and equipped to raise these issues with ICD recipients. The committee noted that specific issues were relevant where a person was thought to be entering their last days of life. The committee wished to emphasise the importance of health care professionals following the guidance in the Care of the dying adult guideline in these circumstances.