Reconditioned Pacemakers: A Safe, Cost-Effective Lifesaving Option for LMICs

 

• Reconditioned pacemakers, prepared using an FDA-approved protocol, performed as effectively as new devices at 90 days, according to findings from the My Heart Your Heart (MHYH) trial presented at AHA 2024.

• The trial included 298 adults from seven low- and middle-income countries (LMICs) who required pacemakers but could not afford new devices. The average age was 70 years, with half of the participants being men.

• Participants were assigned 1:1 to receive either a reconditioned or a new pacemaker, with safety and efficacy assessed at two weeks in-hospital and up to 90 days during follow-up visits.

• By 90 days, there were no deaths or device malfunctions in either group. Device pocket infections requiring removal occurred in three new pacemaker patients and two reconditioned pacemaker patients. Lead dislodgement was observed in five new and six reconditioned pacemaker recipients.

• The study highlights the cost barriers to pacemakers in LMICs and demonstrates the potential of pacemaker recycling to save lives while promoting environmental sustainability.

• Study limitations include a small sample size and short follow-up period of 90 days. Longer-term monitoring is needed to assess issues like battery longevity and late device malfunctions.

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Take-Home Points

1. Reconditioned pacemakers offer a safe and effective alternative to new devices for patients in LMICs.
2. Cost barriers make pacemaker recycling a promising solution for addressing healthcare inequities.
3. No significant safety or efficacy differences were observed between new and reconditioned devices at 90 days.
4. Longer-term studies are necessary to confirm sustained safety and performance of reconditioned devices.
5. Pacemaker recycling is both life-saving and environmentally sustainable.