What happens if a person with a pacemaker/defibrillator dies of something not related to the heart? For example, suppose the person has cancer, and dies from that. What happens when the heart stops beating? Does the pacemaker/defibrillator continue to fire, trying to restart the heart?
I’m not sure if it is true with the current generation of pacemakers, but pacemakers from a few years ago and older will continue to fire after the person has died.
Dying is usually a process. It doesn’t happen all at once. As the heart tissue dies (for whatever reason, such as lack of oxygen) it stops responding to the electrical impulses from the pacemaker and the pacemaker will no longer do anything useful. But the pacemaker will keep trying.
And then they take it out and recycle it to FiFi or Fido!
http://www.ohmidog.com/2009/12/29/used-pacemakers-are-going-to-the-dogs/
The pacemakers don’t keep trying indefinitely, at least not newer ones. My father had one, and the technicians could set a limit on how many times it would try to restart his heart. After the first time it restarted his heart, he had the technician set the number of retries to something lower. The shocks are apparently pretty ghastly, and he wanted to save himself and my mother a repeat of that scene.
Modern pacemakers will only try a set number of times to restart the heart, and older ones will stop when the battery runs down - which probably won’t take that long.
I think you may be conflating ‘pacemakers’ with implantable defibrillators. Only the latter will try to “restart (the) heart”, delivering a relatively large shock to do so. A pacemaker on the other hand, generates only a miniscule impulse; just enough to get the ventricle the contract (and, in some models, the atria as well).
My father had a pacemaker and defib; they may have been integrated into one unit. When he was in hospice care for cancer in 2007 the doctor turned off the defib so it wouldn’t kick on when he passed away of other causes. I don’t know what the state of the art in 2013 is.
This is what we’re doing now for my mom.
It will continue to fire until it is reprogrammed or turned off. This can be done over the phone for many of the newer ICDs. You literally hold the phone over the patient’s chest when they tell you to, and the magic of telemedicine does the rest. (There’s a hostage movie plot device in there somewhere.)
If the person is in the hospital or an ambulance and they don’t have the programming computer handy, they’ll often place a large magnet on their chest. This trips a switch so that the defibrillator doesn’t fire anymore. It’s a big round magnet that works with any brand, any model pacemaker. They will tape the magnet to the chest until someone with the right equipment can come turn it off.
Near the end of life, doctors should be having a conversation with the patient and family about turning the defibrillator part of the device off, especially if the patient requests a DNR. But that conversation happens for less than half of patients with a DNR, and only 4% of the time is it discussed before an ICD is put in. Shocking ending: Implanted defibrillators can bring misery to final hours
It was already used as a plot device in a pay cable drama series.