Abstract 1981: Patients Preferences Regarding Post-mortem Implantable Device Analysis and Retrieval: Potential for a “Device Advance Directive”
Background: The purpose of this study was to determine patients’ preferences for what should be done with their implantable cardiac device after death and willingness to execute a “device advance directive (AD)” authorizing analysis and retrieval.
Methods: 150 patients undergoing routine pacemaker or defibrillator interrogation were enrolled. Questions included what subjects thought was routinely done with devices post-mortem and what they would want done with their implantable device after death.
Results: Subject average age was 67 ± 15 years, and 46% were female. 62 had pacemakers, 72 had implantable cardioverter defibrillators (ICD) and 16 had biventricular pacing defibrillators. Subjects had had devices for a mean of 3.6 ± 4.4 years. When queried about routine post-mortem device disposition, 130/150 (87%) of subjects did not know what was done, 7/150 (5%) thought devices were routinely removed, 8/150 (5%) that devices were buried with the deceased, 4/150 (3%) that they were recycled and 1/150 (< 1%) that they were routinely donated to charity. The majority indicated a willing to have their device interrogated after death (n = 123, 82%) and to have it returned to the manufaturer (n = 118, 79%). In addition, 72% indicated they would sign a device AD. Of these subjects, 91% would be willing to have their device removed and donated for use in needy patients in developing counties and 79% for use in pets. Willingess to undergo post-mortem device interrogation or removal was not associated with age, sex, time since device implantation, or device type.
Conclusions: A large majority of patients with pacemakers and defibrillators are unaware of how their device will be handled after their death, but would be willing to have their device examined post-mortem for quality improvement purposes; the majority would also be willing to formalize their preference for post-mortem device disposition in a “device advance directive” document.