title: Why We Need Postmortem Analysis of Cardiac Implantable Electronic Devices.
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.
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland.
authors.forename: Sabrina
authors.identifier: 0000-0001-6873-0390
authors.initials: S
authors.lastname: Mauf
authors.affiliation: Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Jentzsch
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Laberke
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.affiliation: Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine (ZIFM), University of Zurich, Winterthurerstrasse 190/52, 8057, Zürich, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Bartsch
mesh_terms: D001145:Arrhythmias, Cardiac; D001344:Autopsy; D002423:Cause of Death; D003643:Death; D017147:Defibrillators, Implantable; D006321:Heart; D006801:Humans; D010138:Pacemaker, Artificial
keywords: forensic pathology; forensic relevance; forensic science; implantable cardioverter defibrillator; medical negligence; pacemaker; technical failure