Radiologists should discuss cardiac implant disposal with patients

Dec 31, 2006

Tens of thousands of pacemakers and implantable cardioverter defibrillators are placed inside patients on an annual basis by multispecialty teams that generally include a radiologist, an electrophysiologist, and, of course, the heart specialist.

While a great deal of time and manpower is devoted to implanting these devices correctly, very little thought is given to what will happen to them once the patient has died. The physicians involved in putting in pacemakers and defibrillators -- and that includes the radiologist -- must follow through with a plan for removing them, according to a presentation at the 2006 American Heart Association meeting in Chicago.

A Philadelphia-based researcher suggested that a healthcare professional should be designated to discuss a "device living will" with the patients and/or family members. This will insure that the device is taken out correctly, and possibly sent back to the manufacturer for analysis, pointed out Dr. James Kirkpatrick, an assistant professor of medicine at the Hospital of the University of Pennsylvania in Philadelphia.

Kirkpatrick surveyed 150 patients about the removal and disposal of implantable devices. Of the 108 patients who responded, 72% said that they would be willing to sign a device living will. In addition, 79% said that they were amenable to having the device removed and returned to the manufacturer for analysis, providing information that could be used to advance device development.

"Very few patients who have undergone device implantation have an understanding of the destiny of their device after they die," Kirkpatrick said.

Kirkpatrick also surveyed morticians -- who generally wind up taking out the device -- the majority of whom said they would be willing to comply with a standardized program to ship the devices back to manufacturers.

By Edward Susman
AuntMinnie.com contributing writer
January 1, 2007

ICDs more likely to malfunction than pacemakers, April 26, 2006