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Cardiac implantable electrical devices (CIEDs) are increasingly common interventions for a wide spectrum of cardiovascular diseases. Caring for patients with life-sustaining devices such as CIEDs at the end of life raises legal and ethical challenges. In 2010, the Heart Rhythm Society (HRS) published an expert consensus statement to review the principles and practice of CIED deactivation. This statement addressed a wide range of ethical and legal principles while providing guidance for communication, decision-making, and procedures in a variety of settings. In this article, we provide a summary of the HRS guidelines and highlight the most important features of CIED deactivation for the practicing clinician.

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Management of cardiac electrical implantable devices in patients nearing the end of life or requesting withdrawal of therapy. Review of the Heart Rhythm Society 2010 consensus statement