What Happens to a Pacemaker During Cremation in Canada?
For Canadian families considering cremation when the deceased had a pacemaker (or other implanted medical device), the device must be removed before cremation. This is non-negotiable due to safety concerns with lithium batteries at high temperatures.
Why removal is required
The risk:
- Cremation chambers reach 760-980°C (1400-1800°F).
- The lithium battery inside a pacemaker or similar implant can fail violently at those temperatures.
- A battery failure inside the chamber can cause a small explosion.
Consequences if not removed:
- Damage to the cremation chamber. Repair costs for a damaged cremator commonly run into the tens of thousands of dollars.
- Worker injury. Crematorium operators are close to the chamber when it's loaded and can be hurt by flying fragments or the concussive force of a battery rupture.
- Operational disruption. A damaged cremator is out of service for repairs, which can back up a funeral home's entire cremation schedule.
Industry standard: the Cremation Association of North America's Model Cremation Law treats removal of pacemakers and other battery-powered implants as a precondition of cremation,[1] and Ontario has written the same requirement directly into its crematorium regulations.[2] Canadian crematoria require removal before a body is accepted for cremation.
Devices that need removal
Most common:
Pacemakers. Single-chamber, dual-chamber, or biventricular units, all powered by a lithium battery and typically implanted in the upper chest.
Implantable cardioverter defibrillators (ICDs). Similar placement to a pacemaker, also lithium battery powered, and subject to the same removal requirement.
Cardiac resynchronization therapy (CRT) devices. Used for heart failure, sometimes combining pacing and defibrillation in one unit, also lithium powered.
Other lithium-battery implants:
Implanted insulin pumps. Used in some diabetes management cases; lithium battery powered.
Neurostimulators. Used for chronic pain, Parkinson's disease (deep brain stimulators), some depression treatments, and epilepsy.
Drug infusion pumps. Used for intrathecal pain management and other targeted medication delivery; lithium battery powered.
Some cochlear implants. Certain models include an internal lithium battery; others are external-processor only and don't need removal.
Bladder or bowel stimulators. Used for incontinence management; lithium battery powered.
The rule that matters is simple: if the implant contains a battery, it needs to come out before cremation.
Devices that don't need removal
Without a battery, no removal is required:
- Joint replacements (hip, knee, shoulder)
- Stents (cardiac or vascular)
- Plates, screws, and other orthopedic hardware
- Surgical clips and staples
- Breast implants and most cosmetic implants
- Dental implants
- IUDs
The removal process
Who: typically a funeral home's embalmer or funeral director. Occasionally a hospital removes the device before releasing the body to the funeral home. In Ontario, the crematorium regulations restrict who may perform the removal to a licensed Funeral Director – Class 1 or a legally qualified medical practitioner.[2]
Setting: the funeral home's preparation room, using standard mortuary equipment.
Process: the body is prepared for the procedure, the device is located (typically in the upper chest, near the collarbone), a small incision is made over the device, the device is removed, and the incision is closed. The work is done with the same care given to any other part of body preparation, so the body's presentation for viewing isn't affected.
Time: typically 15 to 30 minutes.
Cost
Typical added charge: $200 to $500, on top of the funeral home's other services. The exact figure depends on the provider's pricing and whether it's itemized separately or bundled into a cremation package.
Generally non-negotiable — a crematorium won't accept a body with an unremoved battery-powered implant, so the fee is effectively mandatory once cremation is chosen.
After removal — what happens to the device
Standard disposal: removed devices that aren't donated are handled as medical waste under provincial regulations, with the lithium battery managed under hazardous-waste rules because of fire and chemical-burn risk.
Donation programs (where available): the best-known program is Project My Heart, Your Heart, a partnership between the University of Michigan's Frankel Cardiovascular Center, World Medical Relief, and participating funeral homes that reconditions still-functional donated pacemakers for patients in lower-income countries who couldn't otherwise afford one.[3] Participation depends on the device having enough remaining battery life and on the funeral home (or family) choosing to take part — not every funeral home participates, and Canadian participation is more limited than in the US, where the program originated.
Manufacturer recycling: some device manufacturers run their own take-back or recycling programs for lithium and rare-metal recovery; availability varies by manufacturer.
How the funeral home knows about a pacemaker
Family informs the funeral director. Funeral homes routinely ask about pacemakers and other implants during arrangement meetings, precisely because the answer changes what has to happen before cremation.
Hospital or medical records. If the death occurred in hospital, the discharge or death record usually notes any implanted devices.
Pacemaker ID card. Most pacemaker recipients are given a wallet card noting the manufacturer and model, which families sometimes find among the deceased's belongings.
Physical examination. A surgical scar over the upper chest during body preparation is a visual cue that prompts the funeral director to check further.
Burial doesn't require removal
Pacemaker removal is generally not required for burial. The lithium battery poses no meaningful risk buried in the ground, and it degrades naturally over time. A small number of cemeteries have their own preferences, and some environmental advocates argue for removal on environmental grounds, but as a rule, Canadian burials proceed with the device left in place. If a family switches from cremation to burial, there's no need to remove the device first.
Pre-planning consideration
Anyone pre-planning their own funeral who has a pacemaker or similar device should note its existence somewhere the family and funeral home will actually see it — in a funeral pre-planner, alongside other medical information kept for the executor, or discussed directly with family. The main thing to flag is that choosing cremation means the device will be removed as a routine part of preparation, at the added cost noted above; choosing burial avoids that step.
Provincial regulation
Ontario has written the removal requirement directly into the regulations under the Funeral, Burial and Cremation Services Act, 2002 (O Reg 30/11), including who is permitted to perform the removal.[2] Other provinces impose an equivalent requirement through their own funeral, cremation, and cemeteries legislation, and the Cremation Association of North America's Model Cremation Law — which most Canadian crematoria follow as an industry standard — treats removal as a precondition of cremation regardless of province.[1] The exact regulatory citation differs by province; a funeral home operating in that province will know its specific requirements.
Alternative — aquamation
Aquamation (alkaline hydrolysis) uses a heated chemical bath rather than flame, at lower temperatures than flame cremation. Some providers still recommend removing a pacemaker beforehand as a precaution, though the explosion risk that drives the flame-cremation rule is less applicable to the process. Aquamation availability in Canada remains limited to a handful of providers, so this is a niche consideration for most families.
What we focus on at It's Simple Will
The Funeral Pre-Planner can capture medical information including implanted devices — useful for funeral home coordination at time of need.
Related guides
Citations & sources
- [1]Cremation Association of North America — Model Cremation Law — Cremation Association of North America
- [2]Funeral, Burial and Cremation Services Act, 2002, O Reg 30/11 (Ontario — pacemaker and radioactive implant removal before cremation) — Government of Ontario
- [3]Project My Heart, Your Heart — pacemaker donation and reuse program — University of Michigan Frankel Cardiovascular Center
Frequently asked questions
Why must pacemakers be removed before cremation?
The lithium battery inside a pacemaker can fail catastrophically at cremation temperatures, which run 760-980°C (1400-1800°F). A battery rupture in the chamber can damage the cremator (the CANA Model Cremation Law and Ontario's crematorium regulations both treat this as a safety requirement), and it can injure crematorium staff. Removing implanted electronic devices before cremation is standard, required practice across Canada.
Who removes the pacemaker?
Typically a funeral home's embalmer or funeral director, trained for the procedure. Occasionally a hospital removes the device before releasing the body to the funeral home. In Ontario, the regulations under the Funeral, Burial and Cremation Services Act specify that only a licensed funeral director or a physician may remove a pacemaker or radioactive implant.
How is removal done?
It's a brief surgical procedure done during body preparation — a small incision over the device (typically upper chest), removal of the device, and closure of the incision. It typically takes 15 to 30 minutes and is a routine part of funeral home preparation-room work.
What about other implanted devices?
The same rule applies to any lithium-battery implant — ICDs (implantable cardioverter defibrillators), implanted insulin pumps, neurostimulators (for pain, Parkinson's, or epilepsy), drug infusion pumps, and some lithium-powered hearing aids or cochlear implants. Implants without a battery — joint replacements, stents, plates and screws, surgical clips, breast implants, dental implants, IUDs — do not need to be removed.
What's the cost?
Typically $200 to $500 added to the funeral home's services, depending on the provider and the complexity of the removal. It's a minor cost relative to the potential damage to the cremation chamber if the device isn't removed, and it's effectively non-negotiable — a funeral home won't proceed with cremation until the device is out.
What happens to the removed device?
Most removed devices are handled as medical waste under provincial regulations, with the lithium battery managed according to hazardous-waste rules. Some working pacemakers are instead sent to device-reuse programs — the best-known is Project My Heart, Your Heart, run by the University of Michigan's Frankel Cardiovascular Center with funeral-home partners, which reconditions donated pacemakers for patients in lower-income countries. Participation depends on the funeral home and whether the family consents.