Priority 24 from the Advanced Heart Failure PSP

UNCERTAINTY: What is the optimum time to discuss deactivation of ICDs (implants) and discuss palliative care with people with advanced heart failure? (JLA PSP Priority 24)
Overall ranking 24
JLA question ID 0098/24
Explanatory note

No significant evidence for people with advanced heart failure 
Evidence

 No systematic reviews on this topic in past five years 
Health Research Classification System category  Cardiovascular
Extra information provided by this PSP
Original uncertainty examples Can patients have more information about their ICD's prior to being implanted as many seem shocked when discussions take place about deactivating them at the end of their lives ~ At what stage to patients want to discuss deactivation of ICDs and what are their thoughts on this? Ditto question to cardiology teams? What is the optimum time to refer for palliative care input? How can we support heart failure specialists to embrace future care planning discussions and recording these wishes? ~ How and when should we discuss ICD deactivation?
Submitted by  3 x health professionals
PSP information
PSP unique ID 0098
PSP name Advanced Heart Failure
Total number of uncertainties identified by this PSP. 65  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 13 February 2019