Cardiovascular implantable electronic device function and longevity at autopsy: an underestimated resource

Area of Science:

• Cardiology
• Biomedical Engineering
• Public Health

Background:

• Postmortem cardiovascular implantable electronic device (CIED) retrieval for reuse is feasible and safe.
• Previous studies show a low yield of reusable CIEDs (17%-30%).

Purpose of the Study:

• To test if a systematic protocol for CIED acquisition, interrogation, reprogramming, and analysis increases the identification rate of reusable devices.
• To evaluate the functional status and projected longevity of postmortem CIEDs.

Main Methods:

• Over 6 years, all autopsy subjects with CIEDs were enrolled in the Johns Hopkins Post-Mortem CIED Registry.
• CIEDs were systematically retrieved, interrogated, reprogrammed, and submitted for manufacturer analysis.

Main Results:

• Out of 84 autopsies with CIEDs, manufacturer analysis revealed device statuses and potential issues.
• Over 60% of pacemakers and over 50% of defibrillators showed normal function with projected longevities exceeding 7 years.

Conclusions:

• A systematic protocol for postmortem CIED retrieval and analysis significantly improves the identification of functional devices for reuse.
• Establishing a national "CIED donor network" could support charitable efforts in underserved regions.