A pacemaker is a small electronic device surgically placed in the chest to regulate heart rhythm using electrical pulses. After a person with a pacemaker passes away, specific procedures are necessary to manage the device, especially if cremation is planned. This article explains the reasons and steps involved in handling a pacemaker following death.
Understanding the Need for Deactivation
Pacemakers and implantable cardioverter-defibrillators (ICDs) contain batteries and electronic components that pose a safety risk if not managed properly after death. The primary concern arises during cremation, where extreme temperatures can cause these devices to explode. Cremation chambers reach around 1000 degrees Celsius, and the sealed casing of pacemakers, especially those with lithium batteries, can build pressure, leading to an explosion. Such an event can damage crematorium equipment and facilities, potentially injuring staff.
Exploding devices can also release harmful substances, including metals and chemicals, into the environment. For these reasons, many countries and states regulate the removal of pacemakers and similar devices before cremation. Deactivating the device renders it inert, making it safe for subsequent processes. Even if cremation is not chosen, deactivation and removal are often recommended for environmental considerations.
The Deactivation Process
Deactivating a pacemaker typically involves using a specialized magnet. This non-invasive procedure places the device into a “magnet” mode, which suspends its therapeutic output. For pacemakers, this means they will pace at a fixed rate, no longer responding to the heart’s intrinsic activity. For ICDs, magnet application primarily suspends the shock therapy function, preventing the device from delivering electrical shocks.
The magnet is placed directly over the skin where the device is implanted, usually just beneath the collarbone. Deactivation is often instantaneous upon magnet placement. This action does not destroy the device but temporarily alters its function; normal operation would resume if the magnet were removed. Trained healthcare professionals, such as nurses or physicians, or qualified funeral home staff, typically perform this procedure.
Post-Deactivation Device Management
Following deactivation, the pacemaker is typically removed from the body. This is a standard procedure, whether the deceased is to be cremated or buried. Morticians or hospital staff usually perform this small surgical procedure, making an incision over the implant site to extract the device and its attached wires. The incision is then closed with a few small stitches.
After removal, these medical devices are usually disposed of as medical waste. Some programs exist for the donation or recycling of pacemakers, though this is less common and depends on specific initiatives and the device’s condition. Recycled devices, after sterilization and refurbishment, may be used to help individuals in need globally. The decision regarding disposal or potential donation is often made in consultation with the family.
Communicating with Professionals
Clear communication with relevant professionals is important when a person with a pacemaker passes away. Inform healthcare providers and funeral home personnel about the pacemaker as soon as possible after death. These professionals are well-versed in the necessary steps for deactivation and removal.
Funeral directors routinely ask about implanted devices to ensure safety regulations are met, especially concerning cremation. They can guide families through the process, ensuring the device is handled correctly and respectfully. Confirming all necessary steps are taken according to family wishes and local regulations helps ensure a smooth process.