---
abstract: |
Cardiologists implant permanent pacemakers widely for indications like sick sinus syndrome and complete heart block. The guidelines for such implantations are well established1. However, in developing countries like India, all patients who need pacemakers do not receive them because of financial constraints. Even when such patients get a pacemaker, it is often a more affordable VVI pacemaker rather than the costly DDD pacemaker. The lack of a health insurance scheme and improper social support programs prevent the more widespread implantation of appropriate pacemakers.
However, in the developed countries and in affluent pockets of developing countries like India, the pacemaker implantation rates are quite high. Often permanent pacemakers are implanted in the very old and people with predicted brief longevities, due to medico-legal and other social reasons. There are quite a few instances when pacemakers are explanted within a year or even within a few months. This is often due to the unfortunate death of the patient due to unrelated causes. Such pacemakers have battery lives, which are near normal. These can be explanted from the dead patient after taking consent from the relatives and “refurbished” for use in another needy patient. Refurbishing involves proper re-sterilization, checking of battery life, pacing mode and other parameters and re-labelling with the current parameters including predicted battery life. These refurbished pacemakers are a suitable alternative for the financially ‘no option’ group of patients who otherwise would not afford a pacemaker. These can last nearly as long as the original pacemakers. Even pulse generators whose shelf lives have expired can also be resterilised and used gainfully for the economically deprived.
altloc:
- http://www.ipej.org/0401/anil.htm
chapter: ~
commentary: ~
commref: ~
confdates: ~
conference: ~
confloc: ~
contact_email: ~
creators_id: []
creators_name:
- family: R
given: Anilkumar
honourific: ''
lineage: ''
- family: J
given: Balachander
honourific: ''
lineage: ''
date: 2004-01
date_type: published
datestamp: 2005-04-17
department: ~
dir: disk0/00/00/42/35
edit_lock_since: ~
edit_lock_until: ~
edit_lock_user: ~
editors_id: []
editors_name:
- family: Singh
given: Balbir
honourific: ''
lineage: ''
- family: Lokhandwala
given: Yash
honourific: ''
lineage: ''
- family: Francis
given: Johnson
honourific: ''
lineage: ''
- family: Gupta
given: Anup
honourific: ''
lineage: ''
eprint_status: archive
eprintid: 4235
fileinfo: /style/images/fileicons/text_html.png;/4235/1/anil.htm|/style/images/fileicons/application_pdf.png;/4235/2/anil.pdf
full_text_status: public
importid: ~
institution: ~
isbn: ~
ispublished: pub
issn: ~
item_issues_comment: []
item_issues_count: 0
item_issues_description: []
item_issues_id: []
item_issues_reported_by: []
item_issues_resolved_by: []
item_issues_status: []
item_issues_timestamp: []
item_issues_type: []
keywords: Refurbishing Pacemakers
lastmod: 2011-03-11 08:55:57
latitude: ~
longitude: ~
metadata_visibility: show
note: ~
number: 1
pagerange: 1-2
pubdom: TRUE
publication: Indian Pacing and Electrophysiology Journal
publisher: Indian Pacing and Electrophysiology Group
refereed: TRUE
referencetext: |-
1. Gregoratos G, Abrams J, Epstein AE, Freedman RA, Hayes DL, Hlatky MA, Kerber RE, Naccarelli GV, Schoenfeld MH, Silka MJ, Winters SL, Gibbons RI, Antman EM, Alpert JS, Hiratzka LF, Faxon DP, Jacobs AK, Fuster V, Smith SC Jr; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. American College of Cardiology/American Heart Association/North American Society for Pacing and Electrophysiology Committee.ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines). J Cardiovasc Electrophysiol. 2002 Nov; 13(11): 1183-9.
2. Namboodiri KKN, Sharma YP, Bali HK and Grover A. Re-use of Explanted DDD Pacemakers as VDD- Clinical Utility and Cost Effectiveness. Indian Pacing Electrophysiol. J. 2004;4(1):3-9
3. Efficacy and safety of refurbished pacemakers: 17 years followup of an international collaborative programme . J.Balachander, R Anilkumar, M.Sampath, KR Sethuraman, S.Chandrasekhar,Bernard Dodinot. Stimucoeur; 2003, 31:3, 190-193.
4. Sethi K K, Bhargava M, Pandit N, Mohan J C, Arora R, Khanna S K, Khalilullah M. Experience with recycled cardiac pacemakers. Indian Heart J 1992, 44 (2): 91-93.
5. Rosengarten M, Chiu R, Hoffman R A. A prospective trial of new versus refurbished cardiac pacemakers: A Canadian experience. Can J Cardiol; 5(3): 155-60.
relation_type: []
relation_uri: []
reportno: ~
rev_number: 14
series: ~
source: ~
status_changed: 2007-09-12 16:57:22
subjects:
- ipej
succeeds: ~
suggestions: ~
sword_depositor: ~
sword_slug: ~
thesistype: ~
title: 'Refurbishing Pacemakers: A Viable Approach'
type: journalp
userid: 4424
volume: 4