41
Likelihood of
pacemaker
dependency
Frequency
of ICD
implant Typical ICD indications
Typical issues affecting
nonarrhythmic quality
of life and mortality
Infrequent Infrequent Primary prevention due
to CM
Respiratory failure
Heart failure
Infrequent Moderate Primary prevention due
to CM
Respiratory failure
Heart failure
Moderate Moderate Primary prevention due to
VA risk
Respiratory failure
Heart failure
Infrequent Infrequent Primary prevention due to
VA risk
Normal general
population causes
Frequent Frequent Primary prevention due to
VA risk
Heart failure
Rare Rare Normal general population
indications
Normal general
population causes
Moderate Rare Primary prevention due to
le ventricular dysfunction
Respiratory failure
Heart failure
Infrequent Moderate Primary prevention due to
le ventricular dysfunction
Heart failure
Respiratory failure
Shared decision-making and end-of-life decisions
1 C-EO 4. In patients with NMD who have an ICD and are
undertaking advanced care planning, discussing the option
of deactivation of ICD shock therapy is recommended.
1 C-EO 5. In patients with NMD who have an ICD and are
experiencing VAs with shocks refractory to available
therapies, discussion of management of ICD therapy
including shock deactivation is recommended with careful
attention to the patient's goals of care.
2a C-EO 6. In patients with NMD who have a pacemaker or ICD
and who are nearing the end of life, if the patient or their
healthcare decision maker requests pacing inactivation, it is
reasonable to comply after education on the consequences
of inactivation with careful attention to the patient's goals
of care.
(cont'd)
