Some patients also said that they would never want their ICD to be deactivated because this was the equivalent to suicide and therefore against their faith. Explanation of quality assessment: moderate methodological limitations in the studies contributing to this sub-finding; minor concerns about the coherence of the finding; partial relevance due to the contributing studies being conducted outside of the UK; moderate concerns about inadequacy as there was a relatively small amount of evidence which lacked depth. There was an overall judgement of very low confidence in this sub-finding due to the concerns regarding the methodological limitations, relevance and adequacy. Review sub-finding 3: Not wanting to deactivate Some people would not consider living without their ICD because they believed it was keeping them alive. Some felt that the ICD should always be replaced when the batteries ran out, regardless of other circumstances. They also described that they would chose life at all costs and would not want to deactivate their ICD when it could extend life. Others were also scared to deactivate their device. Some ICD recipients could not identify any situations in which they would chose to deactivate their device, describing this as a no win situation . Explanation of quality assessment: moderate methodological limitations in the studies contributing to this sub-finding; moderate concerns about the coherence of the findings due to conflicting reports regarding patients and family members wanting to deactivate their device; partial relevance due to the contributing studies being conducted outside of the UK; moderate concerns about inadequacy as there was a relatively small amount of evidence which lacked depth. There was an overall judgement of very low confidence in this sub-finding due to the concerns regarding the methodological limitations, relevance and adequacy. 