Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator Deactivation

Dario Pasalic; Halena M. Gazelka; Rachel J. Topazian; Lillian C. Buchhalter; Abigale L. Ottenberg; Tracy L. Webster; Keith M. Swetz; Paul S. Mueller

doi:10.1177/1049909115595017

Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator Deactivation

Dario Pasalic, Halena M. Gazelka, Rachel J. Topazian, Lillian C. Buchhalter, Abigale L. Ottenberg, Tracy L. Webster, Keith M. Swetz, Paul S. Mueller

General Internal Medicine

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

The presence of cardiac pacemakers and defibrillators complicates making end-of-life (EOL) medical decisions. Palliative care/medicine consultation (PCMC) may benefit patients and primary providers, but data are lacking. We retrospectively reviewed 150 charts of patients who underwent device deactivation at our tertiary care center (between November 1, 2008, and September 1, 2012), assessing for PCMC and outcomes. Overall, 42% of patients received a PCMC, and 68% of those PCMCs specifically addressed device deactivation. Median survival following deactivation was 2 days, with 42% of deaths occurring within 1 day of deactivation. There was no difference in survival between the groups. The EOL care for patients with implanted cardiac devices is complex, but PCMC may assist with symptom management and clarification of goals of care for such patients.

Original language	English (US)
Pages (from-to)	966-971
Number of pages	6
Journal	American Journal of Hospice and Palliative Medicine
Volume	33
Issue number	10
DOIs	https://doi.org/10.1177/1049909115595017
State	Published - Dec 1 2016

Keywords

cardiac pacemaker
cardiovascular implantable electronic device
end of life
implantable cardioverter-defibrillator
medical ethics
palliative care

ASJC Scopus subject areas

General Medicine

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Pasalic, D., Gazelka, H. M., Topazian, R. J., Buchhalter, L. C., Ottenberg, A. L., Webster, T. L., Swetz, K. M., & Mueller, P. S. (2016). Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator Deactivation. American Journal of Hospice and Palliative Medicine, 33(10), 966-971. https://doi.org/10.1177/1049909115595017

Pasalic, D, Gazelka, HM, Topazian, RJ, Buchhalter, LC, Ottenberg, AL, Webster, TL, Swetz, KM & Mueller, PS 2016, 'Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator Deactivation', American Journal of Hospice and Palliative Medicine, vol. 33, no. 10, pp. 966-971. https://doi.org/10.1177/1049909115595017

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abstract = "The presence of cardiac pacemakers and defibrillators complicates making end-of-life (EOL) medical decisions. Palliative care/medicine consultation (PCMC) may benefit patients and primary providers, but data are lacking. We retrospectively reviewed 150 charts of patients who underwent device deactivation at our tertiary care center (between November 1, 2008, and September 1, 2012), assessing for PCMC and outcomes. Overall, 42% of patients received a PCMC, and 68% of those PCMCs specifically addressed device deactivation. Median survival following deactivation was 2 days, with 42% of deaths occurring within 1 day of deactivation. There was no difference in survival between the groups. The EOL care for patients with implanted cardiac devices is complex, but PCMC may assist with symptom management and clarification of goals of care for such patients.",

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Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator Deactivation

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