Re-used pacemakers--as safe as new? A retrospective case-control study

Abstract

Re-use of pacemakers is of interest in an era of declining health care resources if it is proven safe and without risks to the patients. In order to investigate the safety of re-use of pacemakers we performed a retrospective case-control study. One hundred patients, who received a re-used pacemaker, were matched for date of implantation and mode (AAI; VVI; DDD) to 100 others who received a newly manufactured pacemaker and were followed for a mean of 32 +/- 11 months for complications defined as infections and signs of pacemaker malfunction and pacemaker replacement earlier than anticipated due to battery depletion. Patients who received re-used pacemakers were significantly older than those who received new units (79 +/- 9 vs 68 +/- 21 years; P < 0.0001). The number of complications did not differ significantly between groups. There were no early replacements due to battery depletion in either of the two groups. A cost-benefit analysis revealed a substantial economical advantage.

Conclusions: The re-use of pacemakers can be carried out without increased risk to the patients provided a proper routine for technical control and sterilization is followed. Re-use means substantial savings which possibly could make advanced pacemaker treatment available to all eligible patients irrespective of age. Whether re-use is feasible with implantable defibrillators remains to be determined.