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In Mexico, a call for sterilized, used pacemakers as implants in new study

by John R. Fischer, Senior Reporter | November 08, 2017
Cardiology Infection Control Medical Devices
A new study proposes using sterilized,
used pacemakers as implants in patients
who cannot afford new ones
Physicians in Mexico are proposing to address various heart conditions by implanting patients with sterilized, used pacemakers.

Researchers presented their findings in a study at the 30th Mexican Congress of Cardiology, held from November 2 - 5 in Guadalajara, Mexico, arguing that reusing pacemakers will enable access to necessary treatments for people who cannot afford new devices.

“According to government reports, more than half of the population in Mexico does not have access to social security or private insurance that covers a pacemaker implant, and 44% live in poverty,” Dr. Carlos Gutiérrez, a cardiologist at the General Hospital of Mexico "Dr. Eduardo Liceaga" in Mexico City and the lead author of the study, said in a statement. “This suggests that many Mexicans cannot afford a pacemaker. Previous studies have shown the safety of reusing pacemakers after sterilization.”
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No reports indicate the number of pacemaker implants that take place annually throughout the whole country, though physicians at the General Hospital of Mexico implant close to 150 new pacemakers each year, according to Gutiérrez.

The authors conducted their study from 2011 to 2017, implanting donated pacemakers into 33 patients, each with a pacing indication, who were unable to afford a new one or a battery change. Devices were provided by relatives of deceased patients and carried a minimum battery life of six years.

Pacemakers were tested for functionality and were then washed with enzymatic soap and sterilized in an autoclave for 38 minutes. Physicians once again tested functionality following sterilization.

Patients were 52 percent female and ranged in age from 20 to 106 years old with ten suffering from sinus node dysfunction and 23 diagnosed with advanced atrioventricular block. Twenty-five were implanted with a reused device while the other eight received a used generator.

Implants were largely successful with one hematoma resolved without further complications. A follow-up six months later showed no signs of trouble with the implants or patients.

“This was a small study but it shows that with a thorough and standardized sterilization process, explanted pacemakers with a battery life of more than six years can be reused safely,” Gutiérrez said in a statement. “This provides an effective option for patients who cannot afford a new device or a replacement battery. This practice could be implemented in many other centers that have equipment to sterilize and reprogram pacemakers. We also need to promote the donation of pacemakers with little use from deceased patients.”

The Mexican Society of Cardiology is an affiliated member of the European Society of Cardiology (ESC).

Neither the ESC nor the General Hospital of Mexico returned calls for comment. The Mexican Society of Cardiology could not be reached for comment.

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