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Pacemaker reutilization for those in underserved nations: examining preliminary data and future prospects

A Badin, TS Baman, KA Eagle & TC Crawford

The scope of the problem ▪ Many individuals in underserved nations are subjected to symptomatic bradycardia resulting in increased morbidity and mortality due to a lack of access to pacemakers. Promising solution ▪ Pacemaker reutilization promises to provide an alternative solution to overcome the high cost of new devices. Perceived challenges to pacemaker reutilization ▪ Infection and device malfunction rate must be high in reused devices. ▪ The public may not be willing to have their devices explanted. ▪ There are not enough devices to explant and reuse. ▪ It is unethical to reuse devices as this is below standard of care. ▪ The US FDA regulation prohibit pacemaker utilization. Current knowledge and potential solutions ▪ Numerous trials have established safety and efficacy on pacemaker reutilization. ▪ A great majority of device patients are willing to donate devices after death with funeral directors willing to assist. ▪ The cremation rate is rising to more than 50% in the USA, resulting in an increased number of devices that need to be explanted. These devices could be the main resource for device reuse. ▪ When compared with eminent morbidity from bradyarrhythmia with no available alternative, reuse of pacemakers becomes an ethical necessity. ▪ Project My Heart Your Heart is working closely with the FDA to create a proper legal framework.