The Particulars: Little is known aboutpatient attitudes and knowledge about ICDs at the end of life among individuals with heart failure (HF). Research is also lacking on how well these patients can participate in end-of-life decisions.

Data Breakdown: Swedish investigators surveyed ICD recipients with and without HF about their ICD and end-of-life issues. Patients with HF reported having a worse quality of life and were more likely to be depressed or have anxiety. However, only 39% of HF patients discussed the progression of their illness with a doctor. Additionally, just 14% discussed ICD deactivation with their doctor and 8% discussed their wishes with family. Patients with HF also had misconceptions about their ICD delivering shocks at the end of life and what ICD deactivation meant and how it was carried out.

Take Home Pearls: ICD patients with HF appear to have misperceptions about their ICD at the end of life that could interfere with decision making. Greater knowledge about ICDs and their performance at the end of life and discussions with providers and family about these issues should allow these patients to be better prepared when making decisions.