when can the pacemaker be turned off or who turns off the pacemaker

My sister called me to ask this question for her male partners brother.  As she knows i have a pacemaker.  I did not know the answer.  Thought i would ask this knowledgeable group.

His brother is in rehab and has not eaten or drank for a week.  Has a pacemaker, they wanted to know who and when can it be turned off.  As they did not want him to suffer. So far his kidney has shut down.  since it is there to keep the heart beating.  Next week his medicare runs out and will become a private patient.  They believe at that point Hospice can step in.  That is a long time to wait.

Of course she might have to make that decision for me to.  

new to pace

5 Comments

Not sure that it would help

by Gemita - 2022-03-15 06:29:02

https://www.pacemakerclub.com/message/40053/pacemaker-rights

new to pace, We always have the right to refuse treatment but switching off our pacemakers in our lifetime may be seen as assisted dying. 

I do not believe turning off the pacemaker would necessarily mean "dying in peace."  Quite the contrary in many cases with the heart going back to working as it did pre pacemaker.  For some of us the heart might stop but more likely, we would just feel worse.  My feeling is that now organ failure has occurred they will manage his symptoms as well as they can for him to feel comfortable, supporting him through this difficult time so that he will not suffer.  There is no need to cause further suffering by turning off the pacemaker which may or may not hasten death.

Take a look at our Pacemaker Club discussion above on this difficult subject.  Some excellent links were posted.  Another excellent link from our British Heart Foundation on ICD deactivation:-

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/icds-and-end-of-life

I hope for the very best

not sure it would help

by new to pace.... - 2022-03-15 07:12:45

Thank you Gemita will check these out.

new to pace

It Might Not Matter

by Marybird - 2022-03-15 11:26:43

I've looked at information that addresses this question, ( hospice information, end of life discussions,)and my impression is that turning off a pacemaker when a person is terminally ill is really a matter of discussion between the person ( if able), the family or patient's other healthcare decision makers, the doctor overseeing the terminal care, and the cardiologist(s) who have managed the pacemaker. I don't think there is any set protocol, it's really a case by case basis.

If a pacemaker is believed to be prolonging a terminally ill person's life and contributing to the person's discomfort ( such as an ICD that delivers shocks repeatedly to a failing heart, but a pacemaker won't do that) they might turn it off. Otherwise, especially considering a pacemaker will probably not prolong life once other systems start shutting down, the pacemaker would most likely, I think, provide a measure of comfort to the patient as long as the heart still responds to the electrical signals it gets from the pacemaker.

I can tell you that once the person's systems shut down to the point of becoming incompatible with life, the heart will not respond to the pacemaker, even if it's still "activated". Not the way I would have chosen to learn this, but my sister, who also had a pacemaker, died suddenly and unexpectedly in her sleep. We don't know the specific cause(s) of her death, she had pneumonia and had gone to the ER the day before, was sent home with a prescription. She had some underlying pulmonary issues and had been set up with continuing care with a pulmonologist. She also had SSS and A-fib and had some bleeding issues with the Eliquis she was taking. She had been scheduled for a Watchman implant, which was postponed a couple times due to the covid covid covid all the time policies of the healthcare providers and facilities where she was ( as late as Nov. 2021) and she didn't have covid. 

Thing is, that whatever the specific process was that ended my sister's life didn't appear to be stopped or delayed by the presence of a functioning pacemaker, once she reached that point of no return, her heart just didn't respond to its signals. 

Made me realize, I think, that there is no necessity to put instructions to turn off my pacemaker in my written advanced ( and end of life) directives.

My best wishes for peace and solace to your sister and her family.

Mary

 

 

it might not matter

by new to pace.... - 2022-03-15 11:51:56

Thank you Marybird sent your comments to my sister.

  Will put an update when i know what has happened. 

My sister hopes  her  male parther's , brother does not pick that day we all are gathered to celebrate next week our sisters 50th wedding anniversary.

new to pace

When to turn off the PM

by TAC - 2022-03-15 12:45:18

After the person dies, the PM won't make he dead heart beat. The electrical impulses of the PM can only stimulate live myocardial cells. I don't see any reason to rush.

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