Current Conditions of Management of Cardiac Implantable Devices Post-Mortem in the Chugoku District in Japan

Abstract

Background : About 50, 000 cardiac devices are implanted every year in Japan, but there is no uniform policy on how to handle cardiac implantable devices（CID）before cremating persons with CID. More and more family physicians have been attending patients’ deathbed at their home. If it were possible to cremate a deceased person without removing a CID, it would eliminate confusion about whether to remove a CID or not and reduce the risk of infection when a doctor takes a CID out. Purpose : To study current CID－handling policies at all listed crematories in the Chugoku district in Japan. Method : A total of 162 crematories（76 administrators）in 5 prefectures（Tottori, Shimane, Okayama, Hiroshima and Yamaguchi）in the Chugoku district were surveyed by email, fax and/or telephone. Result : Of all crematories in the Chugoku district, 9 crematories（5.6％）（8 administrators）refuse to cremate a body with a CID. A CID must be removed before cremation. Ninety-three crematories（57.4％）（42 administrators）accept a body with a CID with advance notification, but they prefer CIDs to be removed if possible. Sixty crematories（37.0％）（27 administrators）accept a body with a CID with advance notification alone. Conclusion：In the Chugoku district, 94.4％ of crematories will cremate a body with a CID. However, informing crematory staff that a deceased person has a CID beforehand is required and raising awareness of this procedure may be necessary.