Heartbeat: When should patients consider implantable cardiac defibrillator deactivation?

The use of implantable cardiac defibrillators (ICDs) has dramatically improved outcomes for patients with many types of heart disease. Yet, the patient with an ICD faces a difficult decision near the end of life—should the ICD be deactivated and, if so, when? Evidence to support a specific approach to this clinical dilemma is not amenable to standard research approaches because the outcomes are qualitative, not quantitative. Thus, carefully...