Pacemaker/defibrillator evaluation at Los Angeles County Department of Coroner*

Area of Science:

• Forensic Pathology
• Cardiology
• Biomedical Engineering

Background:

• Pacemakers and implantable cardioverter-defibrillators (ICDs) are common implanted devices for cardiac arrhythmia treatment.
• These devices are frequently encountered in postmortem examinations.
• Interrogation of these devices can yield valuable data about cardiac events.

Purpose of the Study:

• To evaluate the utility of pacemaker and ICD interrogation in forensic investigations.
• To illustrate the application of device interrogation in determining cause of death and identification.
• To assess the role of device malfunction in mortality.

Main Methods:

• Cardiac electrophysiology consultants interrogated pacemakers and ICDs in postmortem cases.
• Device data was analyzed to reconstruct cardiac events.
• Twenty cases were evaluated, with four detailed forensic case reports presented.

Main Results:

• Pacemaker and ICD interrogation provided significant information in 20 evaluated cases.
• Device data was instrumental in establishing decedent identification.
• The technique helped determine the cause and time of death, and evaluate potential device malfunction.

Conclusions:

• Detailed evaluation of pacemakers and ICDs offers essential information for forensic pathologists.
• Device interrogation is a valuable tool in selected forensic investigations.
• This method enhances the understanding of cardiac events in postmortem scenarios.