Pacemaker donation: time to give pacemakers a second life?

Have you ever wondered what happens to pacemakers when they’re no longer needed? The answer, in most cases, is that they get thrown away, never to be used again. Pacemaker devices are generally defined as “single use”, meaning they can’t be transferred to another patient – even if they’re functioning well, with plenty of battery life.   Given that an estimated 2 million people die every year from lack of access to pacemakers and defibrillators, though, could we be doing better?   A groundbreaking project in America thinks we can. My Heart Your Heart – which was created by the University of Michigan – is pioneering a way for people to donate old pacemakers to patients in the developing world. If successful, it could be rolled out across the world. Here’s how it works.

What is My Heart Your Heart?

Project My Heart Your Heart began in 2009, when a patient’s husband phoned the Michigan cardiologists with a question. His wife, who had recently passed away, had been using a pacemaker for a heart condition. Was there any way it could be recycled, so it wouldn’t go to waste? The answer, at that point, was that it couldn’t. So the doctors began to explore how they might change the situation.

What did they discover?

They found that many devices with a good battery life would carry on giving lifesaving support if they were transplanted. They also found there was a huge demand for them from clinics across the developing world. The challenge was to find a way to get them safely reconditioned and dispatched to people in those places. So, they’ve been carrying out a trial to show how it can be done.

How does the scheme work?

When a used pacemaker arrives at the clinic, they run a battery test. If the device has at least four years’ life remaining, they remove any patient detail and send it to a specialist reconditioning centre. It’s then tested again, dipped in silicone, and thoroughly cleaned. After that, it’s sent on to one of their partner clinics abroad, such as in Africa or South America.  

Why do patients donate their old devices?

Sometimes it’s because the original device no longer suits their treatment plan and they’re moving to a new type of implant. Sometimes, unfortunately, it’s because they pass away while the device is still in good working order – so their relatives agree to a posthumous donation, to give someone else the chance of benefiting from the pacemaker.

Is consent needed for a donation?

Yes. Without a consent form, the hospital or funeral director can’t recycle the old device when they remove it. But research has found 90% of patients would donate their pacemaker given the chance. They’re just not always aware of the possibility.

Who will get the pacemaker?

Typically, someone with a serious heart condition that would be life-threatening without pacemaker treatment. Since a standard device costs anywhere from €1,500-3,000 (and much more for an ICD or CRT), this would be impossible without intervention. So, for the most critical patients, the donated pacemakers really could mean the difference between life and death.

What will happen if the trial is successful?

The trial is currently ongoing in a range of countries, including Venezuela, Nigeria and Sierra Leone, and the experts hope to complete it next year. All being well, we could start to see the programme being rolled out much more widely around the world.   “If it shows positive results, we’ll be able to scale this up to allow for large-scale pacemaker reprocessing and donations to patients in low-income countries,” says Thomas D. Crawford, M.D., one of the study’s leads.   “It’s a unique project. I don’t believe there’s any other effort on this scale in the world that’s trying to create a blueprint for how to safely recondition pacemakers and offer them to patients at no cost.”

Read on…

  Read more about the project on the My Heart Your Heart website   See the experts explain how it works: Recycled Pacemakers Offer Treatment Outside the U.S.   Learn more about Pacemakers, CRT-ICD devices and Heart Failure Pacemakers on our website