Pacemakers and Cremation: Removal, Safety and Who Does It

A pacemaker should come out before a body is cremated by flame. Its battery can explode in the heat of the chamber, so crematories ask about implanted devices and expect them to be removed first. The funeral home normally arranges the removal. Your part is to tell them about any pacemaker, defibrillator or other implant when you sign the cremation authorization.

Why is a pacemaker removed before cremation?

Pacemakers and implantable defibrillators (ICDs) run on sealed batteries. Flame cremation runs at roughly 1,400 to 1,600°F, according to the Cremation Association of North America (CANA). At that heat, a battery can burst.

Two studies show what that looks like:

• A 2025 experiment in Japan. Researchers heated 13 devices, 7 pacemakers and 6 defibrillators, in a full-scale cremation furnace at 1100°C and at 800°C. All of them exploded, on average about four to five minutes after ignition (4.3 minutes at 1100°C, 5.4 at 800°C). No visible damage to walls, floors or burners was seen afterward. The authors concluded that cremating such devices appears manageable in modern facilities with proper infrastructure, but that guidance has to fit local equipment and training.
• A 2002 survey of UK crematoria. Researchers surveyed UK crematoria and reported that about half experienced pacemaker explosions. They said explosions could cause damage and injury, and that many staff were unaware that defibrillators can also explode.

So the damage is not guaranteed, but the risk is real, and crematories prefer to avoid it. A sudden bang in a chamber that staff are working beside is a safety issue whether or not the building is harmed.

Is removal required by law?

Not by one national law. The 2025 Japanese paper notes that in the United States and Europe, removal or deactivation (particularly of ICDs) is generally recommended but not legally required. What you will actually meet is a mix of state law and crematory policy.

• Texas. A crematory may not knowingly cremate remains containing a pacemaker or other potentially hazardous implant. The authorization form must include a statement about whether the remains contain one. If the person signing knows of an implant, they must tell the funeral director and the crematory, and the funeral director must make sure it is removed first.
• Minnesota. The authorization form must certify whether the body contains an implanted mechanical or radioactive device, such as a pacemaker. If one is found once the body reaches the crematory, a licensed mortician or physician must remove it before cremation.
• Elsewhere. Rules differ by state, and individual crematories can set stricter policies than the law does. Ask the funeral home how it handles implants.

Who removes it, and when?

The funeral home arranges it, usually after the body has been brought into its care and before it goes to the crematory. State law decides who may do it (Minnesota names a licensed mortician or physician), and it is not done by the family. Don't assume the hospital or hospice has done it. If you are not sure, ask the funeral home to check before the authorization is signed.

The device sits in a small pocket under the skin, usually near the collarbone, with leads running to the heart. If there will be a viewing, tell staff, so they can plan the removal and make sure the person looks as you would want.

What if you don't know whether they had a pacemaker?

Check these before you meet the funeral director:

• Medical records or a discharge summary from the cardiologist
• A wallet card from the device manufacturer, which patients are normally given
• A scar or a small raised area under the skin below the collarbone
• Names of the cardiologist or device clinic, who can confirm

If there is any doubt, say so on the authorization form and let the funeral home decide how to check.

ICDs, leadless pacemakers and other implants

Don't limit the question to a classic pacemaker. Tell the funeral home about anything implanted.

A leadless pacemaker is hard to feel from the outside, so medical records matter even more. If you want dental gold back, that is a separate request. See our guide to gold teeth and cremation.

What happens to the device afterward?

It depends on the funeral home and local rules, so ask. Some families want the device returned and some want it donated. Research projects such as Project My Heart Your Heart have collected used pacemakers to study whether they could be safely reused in countries where patients can't afford them. A 2015 report said the project had processed about 15,000 devices and concluded that safe recycling is possible, and its authors proposed seeking regulatory approval for larger trials. Whether a given funeral home takes part is up to them, so ask early.

Does this apply to other kinds of cremation?

CANA says pacemakers and other implants that cannot be exposed to extreme heat and flame do not need to be removed before alkaline hydrolysis (water cremation), except where the law requires it. It lists 26 states where that method is legal as of March 2026. See aquamation vs cremation to compare. For the whole sequence, including where metal ends up, read what happens during cremation.

What does removal cost?

Charges vary, and some funeral homes fold them into other fees. Ask whether there is a separate charge and where it appears. Under the FTC Funeral Rule, a funeral home must give you a General Price List you can keep, so ask for it and compare. Our General Price List guide explains how to read one.

What to do next

1. Find out whether your loved one had a pacemaker, defibrillator or any other implant, and gather the records.
2. Tell the funeral home on the first call, and again when you sign the authorization.
3. Ask who will remove it, when, and what happens to the device.
4. If you are choosing between providers, ask each how it handles implants. See what direct cremation includes for what a basic arrangement covers.

For worries about mix-ups or errors in the process, see can cremation go wrong.