Badi, Nora, MD

Riutta, Sarah, PhD

Sharma, Kavita, MD

Wankowski, Dawn, MS

Zalzaleh, Jaafar, DO

SHARE @ Advocate Health - Midwest

PACEMAKER DEACTIVATION – PERSPECTIVES AMONGST CLINICIANS AND PROVIDERSJaafar Zalzaleh, DO; Kavita Sharma, MD; Dawn Wankowski, MS; Sarah Riutta, PhD; Nora Badi, MD1Department of Hospice and Palliative Medicine, Aurora Sinai Medical Center, Advocate Health, Milwaukee, WI; 2Center for Urban Population Health, Graduate Medical Education Research Support, Aurora University of Wisconsin Medical GroupThere are no any financial interests and conflicts of interest.What we did and why• Inspired by a patient case; pacemaker deactivation at the end of life presents complex ethical and clinical challenges for healthcare providers, particularly cardiologists and palliative care physicians. • To assess different perspectives regarding deactivating pacemakers• Anonymous REDCap survey sent out to Electrophysiology (EP), Cardiology (CV), and Palliative (HP) teams of Advocate Health Midwest (Jan 2025 – March 2025) (71 completed surveys collected)• First steps to make changes Assess the different perspectives Address the need for collaboration17%52%31%What we found• HP largely believes that the most appropriate time for discussion pertaining to pacemaker deactivation is pre-implantation (47%) in comparison to CV (32%) and EP (8%).• HP providers responded that they had a greater comfort level in pacemaker deactivation discussions (70%) compared to CV (41%) and EP (50%) while conversely, EP providers did choose uncomfortable at the highest percentage.What it means and next stepsThere is a difference between providers in Cardio, EP, and Palliative• Appropriate time to discuss pacemakers• Palliative had higher responses answering “pre-implantation”• Although some participants from palliative chose “never”• Interesting to see small amount of EP chose “pre-implantation”• They do conduct these conversations • Comfort level• Palliative more comfortable• EP with highest response for ”uncomfortable”• Involvement in discussion• Reveals palliative is rarely involved in pre-op counseling• Belief that pacemaker deactivation is ever appropriate in end of life• Most survey respondents answered "yes" regardless of specialtyWhat it means and next stepsHighlights the need for clearer guidelines and enhanced communication strategies between specialties and patientsEarly palliative care involvementEducation to enhance comfort level in discussionsThis survey has led to numerous participants reaching out with comments and their own experiences, sparking further conversations on this topicInsights gained may inform educational initiatives and policy development to support compassionate, ethical end-of-life care 

Pacemaker Deactivation: Perspectives Among Clinicians and Providers

https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=1562&context=sciday

Pacemaker Deactivation: Perspectives Among Clinicians and Providers

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SHARE @ Advocate Health - Midwest