Mexican doctors recycle used pacemakers to save money, lives

In Mexico, where more than half of the population doesn’t have access to private health insurance, physicians are successfully recycling donated pacemakers to patients in need, the European Society of Cardiology reported this week.

Forty-four percent of Mexicans live in poverty, Carlos Gutiérrez, MD, said in an ESC release, and the fact that a large portion of the country’s residents lack access to social security and adequate health insurance suggests local cardiac patients may be unable to afford a pacemaker. Gutiérrez and colleagues expanded on previous studies, which have established the safety of recycling used pacemakers, to implant new devices in 33 patients unable to afford their own.

“There is no report of the number of pacemaker implants per year in Mexico, but we implant close to 150 new pacemakers a year in our hospital,” Gutiérrez, who works at the General Hospital of Mexico in Mexico City, said in the ESC release. Between 2011 and 2017, he said, a handful of those implants were reused devices.

Twenty-five patients in the trial cohort of 33 received a reused pacemaker, Gutiérrez said, while eight who couldn’t afford a battery change for their current device were gifted a recycled generator. The devices, which all had at least six years of battery life remaining, were donated by families of deceased patients and implanted in patients after being washed with enzymatic soap and sterilized in an autoclave for 38 minutes.

The patients, who spanned from 20 to 106 years old with an average age of 72, were in need of pacemakers due to either an advanced atrioventricular block or sinus node dysfunction. The procedures went smoothly across the board, barring one haematoma which resolved without complications. Gutiérrez and colleagues recorded zero complications during the 6-month follow-up period.

“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 6 years can be reused safely,” Gutiérrez said. “This provides an effective option for patients who cannot afford a new device or a replacement battery.”

He said Mexico isn’t the only place where this money-saving process can be a reality.

“This practice could be implemented in many other countries that have equipment to sterilize and reprogram pacemakers,” he said. “We also need to promote the donation of pacemakers with little use from deceased patients.”