Manuscript received 22 November 2006; Revised manuscript received 13 December 2006; Accepted for publication 18 December 2006.
Postmortem Interrogation and Retrieval of Implantable Pacemakers and Defibrillators: A Survey of Morticians and Patients
Version of Record online: 21 FEB 2007
Journal of Cardiovascular Electrophysiology
Volume 18, Issue 5, pages 478–482, May 2007
How to Cite
KIRKPATRICK, J. N., GHANI, S. N., BURKE, M. C. and KNIGHT, B. P. (2007), Postmortem Interrogation and Retrieval of Implantable Pacemakers and Defibrillators: A Survey of Morticians and Patients. Journal of Cardiovascular Electrophysiology, 18: 478–482. doi: 10.1111/j.1540-8167.2007.00773.x
- Issue online: 21 FEB 2007
- Version of Record online: 21 FEB 2007
- postmortem analysis;
- advance directives
Introduction: Recent recalls of pacemakers and defibrillators cast a spotlight on product reliability. Universal postmortem device analysis could yield valuable information, but little data exist on the rate and feasibility of device examinations following death. This study investigated how morticians manage pacemakers and defibrillators and surveyed morticians and device patients regarding routine postmortem device interrogation and explantation.
Methods and Results: Seventy-one morticians were surveyed on device interrogation and explantation practices. One hundred fifty patients presenting for routine device interrogation were interviewed regarding preferences for what should be done with devices postmortem and willingness to execute “device advance directives” authorizing analysis and retrieval. The average number of devices annually explanted per mortician was 7 ± 10 (range = 1 to 50). The most common methods of disposal were placement in medical waste (44%) and donation for human reimplantation in developing nations (18%). Only 4% of morticians reported ever returning devices to manufacturers, but 87% agreed that routine explantation and return of devices to manufacturers would be feasible. Eighty-seven percent of device patients had no understanding of how their device would be handled after death. However, a majority (82%) indicated a willingness to have their device interrogated after death, and most (79%) were willing to have it returned to manufacturers. Willingness was not associated with age, sex, time since device implantation, or device type.
Conclusions: Implantable pacemakers and defibrillators are rarely analyzed after patients die. Systematic postmortem device retrieval appears feasible and acceptable to morticians and patients. Further efforts are needed to implement universal postmortem device evaluation.