DF-4 defibrillator downgrade to pacemaker, a novel method of device downgrade for implantable cardioverter-defibrillator patients

Downgrading implantable cardioverter-defibrillators (ICD) is becoming a common clinical scenario in an aging population with increased comorbidities and more widespread use of do-not-resuscitate orders. Therefore, more patients have had ICD therapies deactivated. However, when devices require replacement, it is unnecessary to implant a larger, more expensive defibrillator to keep therapies turned off. We describe a potential solution for patients using current technology.