Deactivation of Cardiac Implantable Electronic Devices (CIEDs) at the End of Life

Romanò, Massimo

doi:10.1007/978-3-030-80112-0_7

Cited by 3 publications

(3 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The question may arise whether to deactivate these devices or to leave them active until the patient’s death [ 39 , 40 , 41 , 42 ].…”

Section: When Is the Right Moment To Discuss Cardiac Implantable Devi...mentioning

confidence: 99%

“…The four ethical principles (autonomy, beneficence, non-maleficence and justice), in conjunction with the criteria of proportionality and appropriateness should lead the final decision [ 40 ].…”

Section: When Is the Right Moment To Discuss Cardiac Implantable Devi...mentioning

confidence: 99%

“…Cardiologists are generally late in dealing with these issues due to cultural, training and emotional reasons [ 43 ]. They feel great discomfort initiating discussion on treatment choices with patients and family members at EoL [ 40 ].…”

Section: When Is the Right Moment To Discuss Cardiac Implantable Devi...mentioning

confidence: 99%

See 2 more Smart Citations

Ten Questions and Some Reflections about Palliative Care in Advanced Heart Failure Patients

Romanò

2022

JCM

View full text Add to dashboard Cite

Heart failure is a clinical syndrome with increasing prevalence, high morbidity and mortality. It is characterized by high symptom burden, poor quality of life and high economic costs. This implies that the heart failure (HF) patients who receive palliative care (PC) have needs similar to cancer patients, but which are often unmet. This paper analyzes the main unresolved issues regarding the relationship between HF patients and the referral to an early PC program. These issues are presented as ten questions related to which patients should be admitted to PC and at what stage of their disease. Furthermore, the barriers opposing to referral to PC, the role of cardiologists and PC physicians within the care team, the gap between the scientific societies’ suggestions and the real world, the right time to promote patients’ awareness and shared decision making, regarding prognosis, end of life wishes and choices, with reference also to cardiac implantable devices’ deactivation, are discussed. These unresolved questions support the need to reevaluate programs and specific models in achieving equal access to palliative care interventions for HF patients, which is still mainly offered to patients with cancer.

show abstract

“…The question may arise whether to deactivate these devices or to leave them active until the patient’s death [ 39 , 40 , 41 , 42 ].…”

Section: When Is the Right Moment To Discuss Cardiac Implantable Devi...mentioning

confidence: 99%

Section: When Is the Right Moment To Discuss Cardiac Implantable Devi...mentioning

confidence: 99%

See 1 more Smart Citation

Ten Questions and Some Reflections about Palliative Care in Advanced Heart Failure Patients

Romanò

2022

JCM

View full text Add to dashboard Cite

show abstract

Harmless Sustainable Energy Resource using TEG with MPPT Based DC-DC Converter for Power Gain in Implantable Medical Devices

Shwetha,

Lakshmi

2024

Trans. Electr. Electron. Mater.

View full text Add to dashboard Cite

Implantable cardioverter defibrillator explantation upon patient request: Clinical and ethical considerations

Romanò

2024

Pacing Clinical Electrophis

View full text Add to dashboard Cite

BackgroundImplantable Cardioverter Defibrillator (ICD) implantation has significantly modified the natural history of patients at high risk of sudden cardiac death (SCD) in various types of heart diseases. However there is a high rate of psychological distress and reduced quality of life in patients with an ICD, more evident in younger individuals. The ICD removal upon patient request is a very rare event and causes many clinical and ethical issues.MethodsThe article discusses the case of a young patient affected by hypertrophic obstructive cardiomyopathy, who underwent implantable cardioverter defibrillator (ICD) implantation as a primary prevention of sudden cardiac death (SCD). Two years after the implantation, the patient repeatedly requested removal of the ICD due to of a significant and untreatable psychological device intolerance.ResultsIntervention became possible only after extensive psychological evaluation, which excluded specific pathology, and the ratification of Italian law 219/2017 on informed consent and advance directives, which guarantees the patient's independent decisions on current and future medical treatment. The explantation was performed 7 years after the implant. The patient is alive and in good health.ConclusionsThe paper debates the issues related to establishing a patient–physician relationship based on respect for the patient's autonomy and experience of illness, in reference to principles such as beneficence and non‐maleficence, and the conflicts that sometimes arise between them.If a paternalistic approach in the patient–physician relationship evolves into a patient‐centered model, it is more certain that the patient's choice is realistically known and shared, and that it is consistent with the patient's values and life goals.The shared decision making (SDM) process and the use of pathology‐specific decision aids are able to transform the informed consent tool, usually related to medical‐legal issues, into an aid for true partnership between the patient and the medical care team.

show abstract

Deactivation of Cardiac Implantable Electronic Devices (CIEDs) at the End of Life

Cited by 3 publications

References 77 publications

Ten Questions and Some Reflections about Palliative Care in Advanced Heart Failure Patients

Ten Questions and Some Reflections about Palliative Care in Advanced Heart Failure Patients

Harmless Sustainable Energy Resource using TEG with MPPT Based DC-DC Converter for Power Gain in Implantable Medical Devices

Implantable cardioverter defibrillator explantation upon patient request: Clinical and ethical considerations

Contact Info

Product

Resources

About