Cardiac conduction devices in the radiologic comparative identification of decedents

Cardiac conduction devices (CCDs), including pacemakers and implantable cardioverter-defibrillators (ICDs), are implanted in a significant part of the population, especially as the population becomes older. CCDs play an important role in forensic medicine; they are a valuable identification tool as the manufacturer information and unique serial numbers of the device can be matched with the medical records of the person of suspected identity after the device has been removed from the body. Radiological examinations such as X-ray or computed tomography (CT) can illustrate specific CCD features. A series of 12 selected cases is presented to highlight the ability of postmortem CT to visualize CCD details, contributing to possible comparative radiological identification in the case of suspected identity without the requirement of invasive removal. To date, unique patient-specific serial numbers, which are usually not radiopaque, cannot be visualized by imaging. However, a positive match of specific CCD radiologic features combined with other peculiar body findings between ante- and postmortem images can lead to a pure radiologic comparative identification.