Leiden University Scholarly Publications

Persistent URL of this record https://hdl.handle.net/1887/4173128

In Collections

This item can be found in the following collections:

Yilmaz, D. (2025)

Navigating complexities in implantable cardioverter-defibrillator therapy: insights, challenges, and patient-centred approaches

Doctoral Thesis
Heart diseases are a leading cause of death worldwide. For patients at high risk of dangerous heart rhythm disorders, an implantable cardioverter-defibrillator (ICD) can save lives. This device monitors the heart's rhythm and delivers a shock when needed to restore normal function. While effective, ICDs involve complex decisions that are often challenging for patients.
My research focuses on improving decision-making around ICDs by promoting shared decision-making, where doctors and patients work together to make choices based on medical facts and the patient’s preferences. To support this, out tean developed a decision aid specifically for Dutch ICD patients. This tool helps patients better understand their options and make decisions aligned with their values. Our study found that patients using the tool were better informed and more satisfied with their decisions.
I also investigated specific issues faced by older ICD patients, whose needs differ from those of younger...Show moreHeart diseases are a leading cause of death worldwide. For patients at high risk of dangerous heart rhythm disorders, an implantable cardioverter-defibrillator (ICD) can save lives. This device monitors the heart's rhythm and delivers a shock when needed to restore normal function. While effective, ICDs involve complex decisions that are often challenging for patients.
My research focuses on improving decision-making around ICDs by promoting shared decision-making, where doctors and patients work together to make choices based on medical facts and the patient’s preferences. To support this, out tean developed a decision aid specifically for Dutch ICD patients. This tool helps patients better understand their options and make decisions aligned with their values. Our study found that patients using the tool were better informed and more satisfied with their decisions.
I also investigated specific issues faced by older ICD patients, whose needs differ from those of younger patients, and highlighted the need for more tailored care. Additionally, I studied how decisions are made to deactivate ICDs in severely ill patients, balancing emotional and medical considerations.
My thesis advocates for patient-centered care, ensuring that ICD treatments are better tailored to individual needs and preferences.
Show less
Shared decision-making
End of Life Care
implantable cardioverter-defibrillator (ICD)
Decision Aids
All authors
Yilmaz, D.
Supervisor
Schalij, M.J.
Co-supervisor
Erven, L. van; egorova, A.D.
Committee
Jukema, J.W.; Stiggelhout, A.M.; Dobbenburgh, J.O. van; Tuinenburg, A.E.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2025-01-07
ISBN (print)
9789465067100

Funding

Sponsorship
Financial support by ABN AMRO, Biotronik, ChipSoft, Hartonderzoek Nederland, Hairtec Haarkliniek, Leiden Universiteits Bibliotheek, Psycholoog Severli and the Dutch Heart Foundation