Postmortem pacemaker reuse: Charity for most but not all

Abstract

The development of the cardiac pacemaker represents one of the most important advances in modern medicine, saving and improving many lives for over 60 years. It is increasingly apparent, however, that the benefits of cardiac pacing have been unevenly applied across the globe, with implantation rates in many low-and middle-income countries (LMICs) 10-100 times lower than in the United States, Canada, and western Europe. 8 This disparity suggests that many thousands of deaths and much preventable morbidity from bradycardia may be occurring in these nations. The high cost of permanent pacemaker hardware is one major barrier to greater pacemaker utilization, and pacemaker reuse has been suggested as one potential solution. 9

Longevity and potential reusability of cardiac implantable electronic devices explanted in funeral homesPublisher

“…Even so, regulation in Spain does not allow the reprocessing and reimplantation of used CIEDs, because re‐sterilization would mean using the devices outside the specifications for which they were manufactured. However, shipment of post‐mortem explanted reusable devices to third LMICs where regulation does allow CIED reuse may provide a vital treatment to patients with no other alternative 20,21 …”

“…However, shipment of post-mortem explanted reusable devices to third LMICs where regulation does allow CIED reuse may provide a vital treatment to patients with no other alternative. 20,21 The donation of used CIEDs to LMICs is not a new concept, different programs in the United States or France collect explanted devices to provide treatment to patients without resources from LMICs. 22,23 Also, a recent study showed that the majority of physicians of the Spanish Rhythm Association were in favor of this type of practice.…”