Mireille Guay, Aubrey Maquiling, Ruoke Chen, Valérie Lavergne, Donalyne-Joy Baysac, Ève Dubé, Shannon E MacDonald, S Michelle Driedger, Nicolas L Gilbert
Racial disparities in COVID-19 vaccination in Canada: results from the cross-sectional Canadian Community Health Survey
CMAJ open
cardiac implantable electronic devices cied heterogeneous group medical devices increasingly sophisticated diagnostic capabilities could exploited forensic investigations however current guidelines lacking clear recommendations topic first aim systematic review provide updated assessment role postmortem cied interrogation give practical recommendations used daily practice secondly authors aim determine rates postmortem cied interrogation autopsy investigations type final rhythm detected close death focus significance documented arrhythmias well role postmortem cied interrogation determination final causetime death potentially fatal device malfunctions systematic search medline scopus aiming identify reports concerning postmortem human cied interrogation performed including systematic screening reference lists case reports letters editors commentaries review articles guidelines excluded along studies related cardiac devices cied data pooled analyzed using fixedeffects metaanalysis models i2 statistic used assess heterogeneity total 25 articles included systematic review enrolling 3194 decedent cied carriers ten studies 40 100 autopsy rate whereas 6 studies autopsy findings variably reported cied interrogation available 22 studies 88 never performed prior autopsy overall rate successful postmortem cied interrogation 89 high heterogeneity among studies mainly due device deactivationbattery discharge twentyfour percent cied carriers experienced sudden cardiac death scd whereas nonsudden cardiac noncardiac death nscd ncd reported 37 30 decedents respectively ventricular tachyarrhythmias recorded 34 overall successfully interrogated cied 62 decedents experienced scd ventricular tachyarrhythmias recorded 40 found nscd ncd clear interpretation etiological role recorded arrhythmias causation death required integration autopsy findings overall potentially fatal device malfunctions detected 12 cases postmortem cied interrogation valuable tool determination cause death may complement autopsy forensic pathologists need know potential utility pitfalls limitations diagnostic examination make tool much reliable possible