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Why We Need Postmortem Analysis of Cardiac Implantable Electronic Devices
Authors:Sabrina Mauf M.D.  Thorsten Jentzsch M.D.  Patrick J. Laberke M.D.  Michael J. Thali M.D.   eM.B.A.  Christine Bartsch M.D.
Affiliation:1. Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Zürich, Switzerland;2. Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland
Abstract:The prevalence of cardiac implantable electronic devices (CIEDs), pacemakers and implantable cardioverter defibrillators (ICDs) is increasing. However, postmortem analysis of CIEDs is not performed routinely. Fourteen consecutive CIEDs were analyzed. The indication for and date of implantation, technical data, CIED reprogramming, heart rhythm disturbances, patient demographics and medical consultations were investigated. Death during the first year after implantation was seen in 54%, whereof 71% consulted a physician within 10 days before death. The time of death was attributed to a particular day in 29%. There was a relationship between CIEDs and cause/manner of death in 50%. Although limited by a small sample size, this study advocates the routine postmortem CIED analysis for forensic and clinical purposes in selected cases. Patients with CIEDs seem to show an increased risk of death during the first year after implantation. The analysis of CIEDs can be helpful in evaluating the time/cause/manner of death.
Keywords:forensic science  forensic pathology  pacemaker  implantable cardioverter defibrillator  technical failure  medical negligence  forensic relevance
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