Abstract：
Cardiac implantable electronic devices have transformed medicine as they improve quality of life and prevent premature death. In palliative care settings, deactivation of these devices must be discussed, particularly at end-of-life. In terminally ill patients it is consensual to recommend implantable cardioverter defibrillator deactivation once shocks are frequent and painful. Concerning pacemakers, the decision to deactivate is controversial and it usually is not an option at patients\' end-of-life, since in pacing-dependent patients, such low heart rates might induce symptoms of bradycardia, with no impact on survival. Regarding cardiac resynchronization therapy, deactivation is not recommended as it can worsen symptoms. Left ventricular assistance device deactivation at end-of-life is a well-accepted practice, since it has the benefit of ending the physical burden associated with the device. Advance care planning should be encouraged and patients should be informed that deactivation is possible.
摘要：
心脏可植入电子设备已经改变了医学，因为它们提高了生活质量并防止了过早死亡。在姑息治疗中，必须讨论这些设备的停用，尤其是在生命的尽头。对于绝症患者，一旦电击频繁且疼痛，建议建议停用植入式心脏复律除颤器。关于起搏器，停用的决定是有争议的，通常不是病人的选择，因为在依赖起搏的患者中，如此低的心率可能会引起心动过缓的症状，对生存没有影响。关于心脏再同步治疗，不建议停用，因为它会使症状恶化。左心室辅助装置在寿命结束时停用是一种公认的做法，因为它有结束与设备相关的物理负担的好处。应鼓励提前护理计划，并应告知患者可能停用。
