We read with interest the CMAJ article on deactivation of implantable cardioverterdefibrillators by Dr. Wan and colleagues.1 We concur that unwanted implantable cardioverter-defibrillator shocks can lead to substantial distress in the last weeks or months of life in patients with terminal illnesses. In our own experience in a large academic centre in Canada, a substantial 18.3% of patients with a terminal diagnosis received a shock in their last month of life.2 In addition, deactivation of implantable cardioverter-defibrillators as part of end-of-life care was not performed in most patients with terminal diagnoses, with only 32.7% of patients undergoing device deactivation after a terminal diagnosis was established and the remaining patients dying with active devices in situ. We also identified a substantial time lag between a formal do not resuscitate order and device deactivation, with a mean time to deactivation of 38 days.2Our current practice is for implantable cardioverter-defibrillators to be deactivated by a member of the electrophysiology team at the patient’s bedside or in a specialized unit. This requirement may contribute to delays in device deactivation and interrupt the dignity of the dying process for patients. In 2020, Dr. Baranchuk and I proposed that remote deactivation be explored as a potential solution to these problems.3 Although technologically feasible, this concept has not been investigated sufficiently, likely because of concerns related to cybersecurity and liability.3 These concerns could be ameliorated through use of a closed-loop system that requires physical actions through a patient surrogate on site in conjunction with the remote electrophysiology team.We believe that it is time for an open discussion of remote deactivation of implantable cardioverter-defibrillators by our professional societies, industry and cybersecurity experts, and further study of its potential positive impact on patient care in the setting of terminal illness.