HRS: Expert Statement Addresses Cardiac Device Deactivation

Statement offers guidance for management of CIEDs in patients nearing the end of life
By Rick Ansorge
HealthDay Reporter

FRIDAY, May 14 (HealthDay News) -- The Heart Rhythm Society has released an expert consensus statement that provides clinicians with guidelines for the management of cardiovascular implantable electronic devices (CIEDs) in patients who are either terminally ill or are requesting device deactivation. The statement was presented May 14 at Heart Rhythm 2010, the Heart Rhythm Society's 31st Annual Scientific Sessions, held from May 12 to 15 in Denver.

The statement was written in collaboration with the American College of Cardiology, the American Geriatrics Society, the American Academy of Hospice and Palliative Medicine, the American Heart Association, and the European Heart Rhythm Association. The full statement will be published in the July edition of Heart Rhythm.

The authors state that patients with decision-making capacity or their surrogate decision-makers have the legal right to refuse or request the withdrawal of any medical treatment or intervention, regardless of whether the treatment prolongs life and its withdrawal results in death. They also state that clinicians who view CIED deactivation as in conflict with their values cannot be compelled to perform the procedure but should refer cases to colleagues who are willing to perform the procedure.

"Most clinicians who care for patients with cardiac devices regard the therapies delivered by those devices to be life-sustaining and for that reason device deactivation is a challenging practice for many clinicians to execute," co-lead author, David Hayes, M.D., of the Mayo Clinic in Rochester, Minn., said in a statement. "It is extremely important for clinicians to have a point of reference and this document provides international guidance for device deactivation in patients with CIEDs."

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