When a patient is nearing the end of their life, health care professionals should be aware of those who have internal cardiac defibrillators and should be considering deactivation in a timely manner to prevent inappropriate shocks at the end of someone’s life, which are painful and distressing for the individual and those close to them. 

Palliative care can help with starting these conversations and coordinating the process. If someone is too unwell to attend the hospital for formal deactivation we have magnets available to take out for those who are dying and have an active device. 

If you have a patient with an active internal defibrillator ( either an ICD or a CRT-D) in situ and you are concerned they are approaching end of life- please consider referring to palliative care for support with conversations around deactivation. If the patient has a Bromley or Croydon GP please consider referral to the Palliative heart failure service at St Christopher’s.  Please see the guidance that we follow and if you have questions or are unsure whether to refer someone please call the hospice for advice.