USA Maclver Interviews and grounded theory analysis 25 heart failure patients with ICDs (mean age 62 years) To determine patient awareness and understanding of ICD deactivation Canada Morrison Survey and coding 112 palliative care professionals (51% physicians, 48% nurses and 1% other) To explore palliative care providers experiences and attitudes of managing ICDs USA Mueller Focus groups and content analysis 17 industry employed allied professionals working in a clinical setting to monitor cardiac implantable electronic devices, who had performed at least one device deactivation To identify issues related to role conflicts and moral distress experienced with the cardiovascular implantable electronic device industry USA Strachan Interviews and grounded theory 24 ICD recipients and 6 participants who declined an ICD (age 26 to 87 years) To examine patient experiences of end of life care issues Canada Svanholm Phenomenological and interpretive approach 11 ICD-recipients (mean age 82.8 years) who were expecting a device replacement within 2 years To identify areas for improvement in discussions between healthcare professionals and patients related to ICDs. Denmark 10.3.3.3 Qualitative evidence synthesis Three findings were identified, with multiple sub-findings. These are described below. Chronic Heart Failure Advanced heart failure and palliative care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Table 147: Finding 1: Attitudes and understanding Sub-finding Statement of sub-finding Awareness ICD recipients and family members were unaware that ICDs could be deactivated. 