ABSTRACT
This chapter discusses implantable cardiac devices, including standard pacemakers or those with cardiac resynchronization therapy, implantable cardioverter defibrillators (ICDs), and ventricular assist devices (VADs). Survival and quality of life may improve significantly for years in many patients receiving an implantable cardiac device through improved symptom management and function. Compared to new advances and indications for implantable cardiac devices, device management for patients experiencing clinical decline or approaching death has received little attention, leaving many unanswered questions. Cost is an important consideration with implantable cardiac devices as it pertains to the benefit versus harm analysis for patients in different settings. Implantable cardiac devices, pacemakers, ICDs, and VADs, in particular, have created exciting opportunities for improved patient quality of life, function, and survival. Palliative care clinicians and teams can collaborate with heart failure (HF) colleagues to address many of the unmet care needs around implantable cardiac devices for HF patients and their families.
