HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy

Lampert, Rachel; Hayes, David L.; Annas, George J.; Farley, Margaret A.; Goldstein, Nathan E.; Hamilton, Robert M.; Kay, G. Neal; Kramer, Daniel B.; Mueller, Paul S.; Padeletti, Luigi; Pozuelo, Leo; Schoenfeld, Mark H.; Vardas, Panos; Wiegand, Debra L.; Zellner, Richard A.

doi:10.1016/j.hrthm.2010.04.033

Cited by 380 publications

(286 citation statements)

References 82 publications

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“…Należy uwzględniać indywidualne życzenia pacjenta, honorując zarówno świadomą zgodę, jak i świado-mą odmowę. Jeżeli pacjenci nie są w stanie podjąć tej decyzji samodzielnie, to należy wysłuchać opinii członka rodziny lub osoby podejmującej decyzje w zastępstwie pacjenta bądź też postąpić zgodnie z oświadczeniem woli pacjenta, jeżeli takie zostało sporządzone [805,808,809].…”

Section: Problemy Dotyczące Końcowegounclassified

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Priori

Blomström‐Lundqvist²,

Mazzanti³

et al. 2015

Kardiol Pol

233

337

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Section: Problemy Dotyczące Końcowegounclassified

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Priori

Blomström‐Lundqvist²,

Mazzanti³

et al. 2015

Kardiol Pol

233

337

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“…In this setting, ICD operation may be more of a burden than a benefit. [57][58][59] When available, a multidisciplinary end-of-life care service involving cardiologists, palliative care specialists, spiritual advisers, and social workers should always be consulted to create an environment that supports patients and those close to D. Muser, J. J. Liang, and P. Santangeli them in various aspects of end-of-life care. A clinical protocol should be developed to create a care plan to identify the patient's views about device deactivation and advanced intensive care.…”

Section: Palliative Carementioning

confidence: 99%

Electrical Storm in Patients with Implantable Cardioverter-defibrillators: A Practical Overview

Muser

Liang

2017

J Innov Cardiac Rhythm Manage

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ABSTRACT. Electrical storm (ES) is an increasingly common medical emergency characterized by clustered episodes of sustained ventricular arrhythmias (VAs) that lead to repeated appropriate implantable cardioverter-defibrillator (ICD) therapies. A diagnosis of ES can be made with the occurrence of three or more sustained episodes of VAs, or of three or more appropriate ICD therapies within 24 hours in patients with implanted devices. ES is associated with poor outcomes in patients with structural heart disease, particularly those with severe left ventricular dysfunction. In large clinical trials involving patients with ICDs for primary and secondary prevention, ES appears to be a predictor of cardiac death, with notably higher rates of mortality soon after the event. ES management is challenging and requires special medical attention with accurate patient risk stratification and a multidisciplinary approach that includes the use of pharmacologic therapies such as antiarrhythmic drugs (AADs) and interventional approaches like catheter ablation, surgical ablation, or sympathetic neuromodulation. Initial management involves determining and addressing the underlying ischemia, any electrolyte imbalances, and/or other causative factors. Hemodynamic support needs to be considered in high-risk patients with unstable VAs or those with severe comorbidities such as low left ventricular ejection fraction, advanced New York Heart Association class, and/or chronic pulmonary disease. Following the acute phase of ES, treatment should shift towards maximizing therapeutic efforts to address heart failure, performing revascularization, and preventing subsequent VAs. In the present manuscript, we offer an overview of the most relevant clinical aspects of ES with regard to novel therapeutic strategies.

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“…ACC, AHA, CCS, ESC), it has only been in the last year that formal deactivation policies have been published, with the support of other specialty agencies including palliative care (Lampert et al 2010;Padeletti et al 2010).…”

Section: Devicesmentioning

confidence: 99%

“…Discontinuation of ICD therapy is an option for eliminating this distress. Ideally, conversations about when ICD therapy discontinuation would be warranted should be initiated at the time of implantation (Lampert et al 2010). Not surprisingly, these early conversations occur infrequently (Goldstein, Mehta, and Siddiqui 2008).…”

Section: Icds and Crt Devicesmentioning

confidence: 99%

See 1 more Smart Citation

The Changing Landscape – Palliative Care in the Heart Failure Patient Population

Slawnych¹,

Simon²,

Howlett³

2012

Contemporary and Innovative Practice in Palliative Care

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HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy

Cited by 380 publications

References 82 publications

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Electrical Storm in Patients with Implantable Cardioverter-defibrillators: A Practical Overview

The Changing Landscape – Palliative Care in the Heart Failure Patient Population

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