A video by Medpage Today featured Miguel Leal, MD, assistant professor (CHS), Cardiovascular Medicine. Dr. Leal gave his perspective about what providers should consider when discussing end-of-life care and implantable cardiac devices with patients.

“The problem becomes when those discussions do not include a plan, an advanced directive, regarding when should the support provided by those devices no longer be indicated,” said Dr. Leal.

Consensus documents on this topic have been developed by the Heart Rhythm Society, emphasizing the need for informed consent conversations well ahead of end-of-life care.

Resources:

• "Video: End-of-Life Talk for Cardiac Devices Doesn't Have to Be a Downer," Medpage Today, April 27, 2017
• Lampert R, et al. 2010 HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. Heart Rhythm 7:1008-1025.