The following is a summary of “Cardiologists’ perspective on termination of pacemaker therapy–an anonymous survey among cardiologists in Germany,” published in the September 2024 issue of Cardiology by Portig et al.
The European consensus statement addressed the right of patients to refuse pacemaker therapy but lacked specific guidance on the deactivation of pacemakers, a growing concern as more patients request withdrawal of the treatment.
Researchers conducted a retrospective study to understand cardiologists’ opinions, concerns, attitudes, and the primary contact persons for such requests.
They sent an anonymous questionnaire to 288 German cardiology departments. The results showed that 48% of cardiology departments responded by sending back 247 completed questionnaires. Most participating cardiologists were experienced based on the duration of the professional activity. Almost all of the respondents regularly performed check-ups of pacemakers. The majority of cardiologists answering the questionnaire were prepared to deactivate a pacemaker upon patients’ requests and had done so. However, in pacemaker dependency, the willingness to withdraw decreases, even if death is imminent, for fear of causing distressing symptoms, a sense of being responsible for patients’ possible immediate death, or fear of legal consequences.
They concluded that the survey highlighted cardiologists’ uncertainties regarding patient-requested pacemaker withdrawal, particularly in dependency cases. European cardiology societies should issue official statements clarifying pacemaker withdrawal’s ethical, legal, and practical aspects.
Source: link.springer.com/article/10.1007/s00392-024-02525-z
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