Start The Difficult Conversation With ICD Patients

Tue, 06/19/2012 - 5:27am
John Mandrola, M.D.

There was a very important article written in the New York Times recently. It highlighted a common medical scenario in my world—the defibrillator (ICD) world.

I am going to talk about ICDs here, but the big picture inherent in this story illustrates the important issue of how best to apply invasive therapy to elderly and sicker patients.

The Times piece delved into medical decision-making when patients present with battery depletion of their defibrillator. The battery longevity of these devices ranges about 5 years. The default among many heart doctors is to assume that patients still need or want their ICD. I can say from personal experience that this is an incorrect assumption. There are other options. The device can be deactivated and left in place, or it can be exchanged for a non-shocking pacemaker.

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