Heart Defibrillators Complicate End-Of-Life Care

Heart defibrillators, "small implants that save lives by sending an electrical jolt to interrupt a potentially fatal heart rhythm and restore normal beating," can pose a "challenge near life’s end, for both patients and their families," The New York Times reports.

"Specialists say that a failing heart often begins to beat in the same type of wildly erratic rhythm that a defibrillator is programmed to recognize and intercept with a jolt. And though doctors and patients routinely discuss end-of-life issues like withdrawing medications and resuscitation attempts, studies suggest that what to do about a defibrillator rarely comes up. On Friday, the Heart Rhythm Society, a professional group representing cardiologists who implant heart devices like defibrillators, plans to issue guidelines in an effort to promote such talks. Among other things, the guidelines, which were developed with other medical organizations, emphasize that doctors should discuss possible device deactivation with patients at the time of implantation and periodically afterward. … An estimated 650,000 people in this country have either a defibrillator or a more complex device that combines a defibrillator and a pacemaker" (Meier, 5/13).

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