title: Reuse of pacemakers: comparison of short and long-term performance.
abstract: BACKGROUND
  In developing economies, there are patients in whom pacemaker implantation is delayed because they cannot afford one. Reused devices have been a solution. To address concerns about safety, a cohort of consecutive patients implanted with a reused pacemaker was compared with a control group.
  
  
  RESULTS
  A cohort of 603 consecutive patients from 2000 to 2010 was studied in an ambispective noninferiority study. The study group patients (n=307) received resterilized pacemakers, and the control group patients (n=296) received a new pacemaker. A combined end point of 3 major outcomes-unexpected battery depletion, infection, and device dysfunction-was analyzed. A total of 85 pacemakers had to be explanted, 31 in the control group (10.5%) and 54 in the study group (17.6%; relative risk, 1.68; 95% confidence interval, 1.1-2.5; P=0.02). Forty-three reached the primary end point, 16 in the control group (5.5%) and 27 in the study group (7.2%; relative risk, 1.3; 95% confidence interval, 0.70-2.45; P=0.794). In terms of individual outcomes, 5 new pacemakers (1.7%) and 11 resterilized pacemakers (3.6%) had unexpected battery depletion (relative risk, 2.12; 95% confidence interval, 0.75-6; P=0.116); 3.7% new pacemakers and 3.2% reused pacemakers had a procedure-related infection (relative risk, 0.87; 95% confidence interval, 0.38-2.03; P=0.46); and 1 pacemaker in the study group malfunctioned.
  
  
  CONCLUSIONS
  Pacemaker reuse is feasible and safe and is a viable option for patient with bradyarrhythmias. Other than the expected shorter battery life, reuse of pacemaker generators is not inferior to the use of new devices.
authors: Instituto Nacional de Cardiología "Ignacio Chávez, Department of Electrocardiology, Juan Badiano 1 Col Sección XVI, Tlalpan 14080, Mexico City, Mexico. santiagonavat@hotmail.com
authors: Santiago
authors: S
authors: Nava
authors: José L
authors: JL
authors: Morales
authors: Manlio F
authors: MF
authors: Márquez
authors: Fausto
authors: F
authors: Barrera
authors: Jorge
authors: J
authors: Gómez
authors: Luis
authors: L
authors: Colín
authors: Josep
authors: J
authors: Brugada
authors: Pedro
authors: P
authors: Iturralde
mesh_terms: D000328:Adult; D000368:Aged; D001919:Bradycardia / Q000628:therapy*; D015331:Cohort Studies; D011211:Electric Power Supplies / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data*; D017743:Equipment Reuse; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors