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Cardiac devices aid in identifying time, cause of death

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Data extracted from pacemakers and other cardiac devices may assist in identifying time and cause of death when autopsy fails to do so, according to findings presented at EHRA Europace – Cardiostim 2017.

“The number of implanted cardiac devices with sophisticated diagnosis functions is increasing, and we thought interrogating them might help to shed light on these unclear deaths,” Philipp Lacour, MD, cardiologist at Charité Medical University of Berlin, said in a press release. “Currently, device interrogation is not routinely performed after autopsy.”

Lacour and colleagues reviewed data collected from cardiac implantable devices of 136 patients with a median age of 76 years autopsied between January 2012 and October 2016.

Among the explanted devices were 100 pacemakers, 19 implantable cardioverter defibrillators, 12 cardiac resynchronization therapy systems and six implantable loop recorders.

Time of death could not be determined exactly by forensic methods in 24.7% of cases.

Information retrieved from the devices was matched with the time and cause of death, which was forensically diagnosed.

In 75.9% of cases, time of death was determined to the minute by analysis of device-related information.

After time of death, lead impedances showed a tendency to rise, Lacour said in the release.

Several cases showed the presence of ventricular tachycardia and fibrillation, which was related to the approximate time of death in many cases.

Artefact sensing was common after explantation, but also between the time of death and autopsy.

“We think device interrogation should be routinely performed after autopsy in all forensic cases” Lacour said in the release. “It helps determine the time and cause of death and identifies device malfunctions that might otherwise have gone unnoticed and should be highlighted to manufacturers and health departments.” – by Dave Quaile

Reference:

Lacour P, et al. Abstract 1302. Presented at: EHRA Europace – Cardiostim 2017; June 18-21, 2017; Vienna.

Disclosure: Lacour reports no relevant financial disclosures.