A coroner's request for closure: the value of the stored electrogram

Irene H Stevenson1, Harry G Mond

  • 1Department of Cardiology, The Royal Melbourne Hospital, Victoria, Australia.

Insights

Pacemaker diagnostics aided post-mortem examination. Pacemaker interrogation revealed a fatal ventricular arrhythmia, not device malfunction, as the cause of sudden cardiac death in a patient with a ventricular pacemaker.

Area of Science:

  • Cardiology
  • Medical Device Technology
  • Forensic Pathology

Background:

  • Pacemaker diagnostics are crucial for troubleshooting device function.
  • Sudden cardiac death necessitates thorough investigation into potential causes.
  • His bundle ablation is a procedure used to treat certain arrhythmias.

Observation:

  • A 58-year-old male patient with a single-chamber ventricular pacemaker and prior His bundle ablation experienced sudden death.
  • Post-mortem pacemaker interrogation was performed.

Findings:

  • Pacemaker interrogation excluded device malfunction as the cause of death.
  • The diagnostic data indicated a fatal ventricular arrhythmia as the primary cause of death.

Implications:

  • Pacemaker diagnostics provide valuable insights even after patient demise.
  • This case highlights the importance of considering arrhythmias in sudden cardiac death evaluations.
  • Understanding pacemaker data can refine post-mortem analyses and improve patient care strategies.

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