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Implantations of implantable defibrillators (ICDs) have increased dramatically over the last few years and pacemaker implantations stay at a high level. Therefore the question often arises as to what to do after the death of a patient with an ICD or pacemaker. There are medical aspects to this issue as well as legal and environmental issues that need to be addressed. If the deceased is to be cremated, an implantable device needs to be explanted and this is also preferable in the case of a burial. Safety measures have to be taken when an implantable defibrillator is removed. There are no legal regulations in the Netherlands about who is responsible for explantation of cardiac devices but in most cases it will be done by the treating physician or a funeral director. Explantation requires a number of instruments: gloves, a scalpel, blunt scissors, insulated tongs, suture set and sticking plaster.