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ICD Deactivation Technical Process — SCE Palliative Medicine MCQ

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ModerateNon-Malignant Palliative CareICD Deactivation Technical ProcessSCE Palliative Medicine

A 72-year-old woman with advanced heart failure and an ICD has discussed deactivation with her care team and decides to proceed. How is ICD deactivation performed?

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Correct answer: B — A cardiac physiologist re‑programmes the device using an external programmer; the shock (defibrillation) function is deactivated while the pacing function may be maintained

In UK practice, ICD deactivation in palliative care is performed non‑invasively by a cardiac physiologist using an external programmer to turn off the shock therapy while allowing pacing to continue if needed. This avoids distressing shocks near end of life and can be done in outpatient, inpatient or community settings. Temporary magnet placement is only for emergency short‑term suppression and is reversible; catheter lab attendance, surgical removal, or battery extraction are unnecessary and inappropriate.

Reference: CUH patient leaflet ‘Deactivating your implantable cardiac defibrillator (ICD)’, approved December 2025; NHS Borders clinical guideline on ICD deactivation, reviewed February 2026, https://www.rightdecisions.scot.nhs.uk/nhs-borders-clinical-guidelines/cardiology/icd-deactivation/