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Societal views of pacemaker reutilization for those with untreated symptomatic bradycardia in underserved nations

Lindsey Gakenheimer1, Dave C Lange, Joshua Romero

  • 1Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|January 21, 2011
PubMed

Insights

Funeral directors, patients, and the public widely support pacemaker reuse programs for low- and middle-income countries (LMIC). This study indicates that establishing pacemaker reutilization initiatives is feasible and warranted.

Area of Science:

  • Cardiac Electrophysiology
  • Global Health Equity
  • Medical Device Reuse

Background:

  • Significant healthcare disparities in cardiac electrophysiology exist between developed nations and low- and middle-income countries (LMIC).
  • Pacemaker reutilization is a proposed solution to address device access in LMIC, but program feasibility and public perception data are limited.
  • Understanding societal views on device reutilization is crucial for developing effective programs.

Purpose of the Study:

  • To investigate the perspectives of funeral directors, patients with cardiac devices, and the general population on the reutilization of previously implanted pacemakers.
  • To assess the feasibility of establishing pacemaker reuse programs by gauging support and identifying potential barriers.

Main Methods:

  • A survey was conducted among 90 funeral directors in Michigan regarding their practices and preferences for post-mortem device disposal.
  • 114 patients with cardiac devices and 1,009 members of the general population were surveyed on their views regarding post-mortem device handling.
  • Data on funeral director experience, cremation rates, and current device disposal methods were collected.

Main Results:

  • The majority of explanted pacemakers (84%) are currently discarded as medical waste or stored without a clear purpose.
  • A significant majority of funeral directors (89%), device patients (87%), and the general population (71%) expressed willingness to donate devices for reuse.
  • Funeral directors reported an average of 21 years of experience and handle approximately 120 deceased individuals annually, with a 35% cremation rate.

Conclusions:

  • A substantial proportion of funeral directors, patients, and the general public support pacemaker reutilization initiatives.
  • The findings suggest that collecting explanted pacemakers for reuse is feasible.
  • Establishing regional pacemaker reutilization programs is warranted to address the burden of symptomatic bradycardia in underserved populations.
Abstract

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