To a cardiologist end of life in a device generally means just one thing - you replace the battery related bit and things get back to normal. I've been thinking about this today because I've been asked to help in an unfortunate and distressing situation not only for the family concerned but also for the staff members. As with a lot of cardiology units we do not implant complex devices such as implantable defibrillators but we admit people who have them. We are also bad at planning end of life care and this I believe also holds true for centres who implant them meaning that when a patient dies the device is still active raising all sorts of issues for grieving families that they could well do without. I hope that centres who implant these devices can take a more proactive role in what to do about them when end of life is near and that everyone else can recognise this as an issue.