Insights into cardiac pacemaker and defibrillator revision/upgrades

Implantation of cardiac implantable electronic device (CIEDs), both pacemakers (PM) and implantable cardioverter defibrillators (ICDs) has dramatically increased in recent years. Cardiovascular disease causes an estimated 30% of all deaths worldwide. In a 14-month period, a consecutive series of 121 devices (76 ICDs and 45 PMs) were collected as part of an IRB-approved device retrieval program. The criteria for devices to be reprocessable are PMs with remaining projected longevity of greater than 4 years and ICDs with battery voltage greater than 2.95V were noted. Our data suggests that 17-20% of device removals in a teaching hospital may be suitable for re-use in countries with developing economies.