Cardiac implantable electric devices in forensic medicine : Overview from the forensic and cardiology perspective

Abstract

In 2021, about 75,000persons in Germany died unnaturally or due to unexplained reasons. As aconsequence, there are difficulties in more precisely identifying the time, cause and circumstances of death. Nevertheless, clarification is crucial not only from the clinical perspective, but these data are of considerable importance in the context of investigative procedures as they can be used to answer numerous legally relevant questions. Cardiac implantable devices (CIED) are of vital importance in the treatment of cardiac arrhythmias. In 2020 about 100,000patients underwent CIED implantation in Germany. Therefore, CIED are present in arelevant proportion of the deceased mentioned above. The valuable source of information represented by postmortal CIED interrogation has been shown in numerous studies. Nevertheless, postmortal CIED interrogation is not routinely performed in the context of forensic medical examinations for reasons of practicability. This article summarizes benefits and limitations of postmortal CIED interrogation from the perspective of forensic medicine and cardiology and gives arecommendation for realization.