Letters1 November 2005Deactivating Implantable Cardioverter DefibrillatorsJames M. Beattie, MD, Michael J. Connolly, MPhil, RGN, and John E. Ellershaw, MAJames M. Beattie, MDFrom Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.Search for more papers by this author, Michael J. Connolly, MPhil, RGNFrom Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.Search for more papers by this author, and John E. Ellershaw, MAFrom Heartlands Hospital, Birmingham B9 5SS, United Kingdom; South Manchester University Hospital, Manchester M23 9LT, United Kingdom; and Marie Curie Palliative Care Institute, Liverpool L25 8QA, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-9-200511010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The review by Berger (1) highlights the complex end-of-life issues posed by the presence of ICDs. This dilemma is particularly difficult for those physicians treating patients who have advanced heart failure, a group that is receiving implantable devices at an increasing rate and whose prognosis is ambiguous. The American College of Cardiology/American Heart Association practice guidelines for chronic heart failure offer the consensus view that such devices are of little benefit in those patients with New York Heart Association class IV symptoms typical of end-stage disease (2).We agree with Berger that formal guidelines do not exist ...