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Decision Memo for Implantable Cardioverter Defibrillators

Today, CMS released the final decision memo on Implantable Cardioverter Defibrillators (ICD) and it included a provision about the shared decision-making (SDM) process that C-TAC advocated for in our comments. C-TAC supported requiring a SDM interaction prior to ICD implantation for certain patients because patients are often confused about the purpose and nature of these devices.

However, CMS did not take our further suggestion that they require any decision aid tool also include information about when and how such devices might be deactivated in the future. We made this suggestion because many patients are unaware of the deactivation option, which is unfortunate as some suffer shocks from these devices at the end of life.  This can be painful and may be counter to their goals of care at that time. C-TAC will continue to advocate for this change in future comment opportunities.

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