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Interrogación con dispositivos electrónicos implantables en el corazón en la autopsia forense: ¿un recurso
Philipp Lacour1, Claas Buschmann2, Christian Storm3
1Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Cardiology (P.L., A.S.P., M.H., P.A., L.-H.B., B.P., W.H., F.B.).
Circulation
|June 20, 2018
Resumen
El interrogatorio postmortem de dispositivos electrónicos implantables cardíacos (CIED, por sus siglas en inglés) ayuda a los patólogos forenses a determinar la causa y el momento de la muerte. Este análisis también ayuda a identificar posibles problemas de seguridad de CIED.
Área de la Ciencia:
- Patología forense
- Cardiología
- Análisis de dispositivos médicos
Sus antecedentes:
- Se recomienda el interrogatorio postmortem de dispositivos electrónicos implantables cardíacos (CIED) en casos sospechosos de muerte súbita cardíaca, pero rara vez se realiza.
- Faltan datos de análisis postmortem del CIED en la patología forense.
Objetivo del estudio:
- Determinar la utilidad de los interrogatorios y análisis de datos del CIED postmortem no selectivos para los patólogos forenses.
- Evaluar el papel del análisis CIED en la determinación de la causa, el mecanismo y el momento de la muerte.
- Identificar posibles problemas de seguridad relacionados con el CIED.
Principales métodos:
- Se extrajeron y interrogaron un total de 151 CIED de 150 sujetos durante un período de 5 años (2012-2017) durante 5368 autopsias.
- Los dispositivos incluidos fueron marcapasos, desfibriladores y grabadores de bucle implantables.
Principales resultados:
- El interrogatorio del CIED ayudó a determinar el momento de la muerte en el 70% y la causa de la muerte en el 60,8% de los casos en los que inicialmente no se determinaron.
- Se identificaron problemas de dispositivo en el 6,0% de los casos, incluidos problemas de hardware, programación y algoritmo.
- Un CIED fue sometido a análisis por parte del fabricante para su evaluación técnica.
Conclusiones:
- El interrogatorio sistemático postmortem de CIED es esencial en medicina forense para la determinación precisa de la causa y el momento de la muerte.
- El análisis del CIED sirve como herramienta crucial para detectar posibles problemas de seguridad relacionados con el CIED.
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