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Reuse of pacemakers is a good solution to make these devices more accessible in developing economies

In developing economies, there are patients in whom pacemaker implantation is delayed because they cannot afford one. Reused devices have been a solution. To address concerns about safety, a cohort of consecutive patients implanted with a reused pacemaker was compared with a control group. This research was conducted in the Department of Electrocardiology at the Instituto Nacional de Cardiología Ignacio Chávez (México), and counted with the collaboration of the Department of Cardiology at Hospital Clínic – IDIBAPS of Barcelona. The last authors of the article published in Circulation are Dr. Josep Brugada, Medical Director at the Hospital Clínic and team leader at IDIBAPS, and Dr. Pedro Iturralde, head of the Electrocardiology Department at the Mexican center.

A cohort of 603 consecutive patients from 2000 to 2010 was studied. The study group patients (n=307) received resterilized pacemakers, and the control group patients (n=296) received a new pacemaker. A total of 85 pacemakers had to be explanted, 31 in the control group (10.5%) and 54 in the study group (17.6%), basically due to normal battery depletion. 1.7% of the new pacemakers and 3.6% of the resterilized ones had unexpected battery depletion; 3.7% new pacemakers and 3.2% reused pacemakers had a procedure-related infection; and 1 pacemaker in the study group malfunctioned.

The investigators conclude that pacemaker reuse is feasible and safe and is a viable option for patient with bradyarrhythmias. The results of the analysis published in Circulation suggest that other than the expected shorter battery life, reuse of pacemaker generators is not inferior to the use of new devices. They are thus a good solution to make these devices more accessible in developing economies.

Reference:
Nava S, Morales JL, Márquez MF, Barrera F, Gómez J, Colín L, Brugada J, Iturralde P. Reuse of Pacemakers: Comparison of Short and Long-term Performance. Circulation. 2013 Mar 19; 127(11):1177-1183.