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.
Abstract:
Pacemaker diagnostics can be useful to troubleshoot both during life and after death. A 58-year old man with a single chamber ventricular pacemaker and a previous His bundle ablation died suddenly. Interrogation of his pacemaker revealed the cause of death not as pacemaker malfunction, but a fatal ventricular arrhythmia.
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