Quality of life and end-of-life issues for older patients with implanted cardiac rhythm devices.

This article provides an overview of quality of life (QOL) and end-of-life issues that pertain to older patients with implanted cardiac rhythm devices. Most patients with implantable cardioverter-defibrillators (ICDs) enjoy similar QOL to that of other patients with cardiac diseases, especially in the absence of ICD shocks. Conventional pacemakers, as well as devices incorporating cardiac resynchronization, can improve QOL in appropriately selected patients regardless of age. In patients approaching the end of life, all devices, but especially ICDs, can adversely impact QOL in patients and families. All patients should have the opportunity to discuss the option of device deactivation.