Can pacemakers used in other people be re-implanted in new patients? The question arises as more and more voices call for eco-responsible medicine and as access to new medical devices remains difficult in many regions.
In fact, this practice of reusing pacemakers that are still in good condition is not new. In Europe, pacemakers were once recovered from deceased people and re-implanted in individuals awaiting treatment. And second-hand pacemakers are already the subject of exchanges between countries with high and low income levels.
However, twenty-five years ago, the practice was banned, particularly in France. The cause is fears, especially of an infectious nature, and mainly theoretical: little data on the risks actually associated with the reuse of these devices has been available until now. The instigators of the My heart your heart (MHYH) trial wanted to fill this gap and more precisely assess the safety of this recycling.
To do this, 298 adults waiting for treatment but not having sufficient economic means to obtain a new pacemaker were recruited in seven countries (Sierra Leone, Venezuela, Nigeria, Kenya, Paraguay, Mexico and Mozambique). These participants were randomized to receive either a reconditioned pacemaker or a new pacemaker.
Reassuringly, after three months of follow-up, patients with recycled pacemakers did not experience significantly more adverse events than others. No deaths or malfunctions were observed. And even, cases of infection requiring removal of the implantable device seemed slightly less frequent among participants who received reconditioned pacemakers. It remains to confirm these results over a longer period of time.
Abstract 4 171 886
Canada
