Recycling From the Heart

The concept of green living  takes on an entirely new meaning in light of new data showing that implantable cardioverter defibrillators (ICDs) can be removed and safely reused in other patients.

Dr. Behzad Pavri, an electrophysiologist at  Thomas Jefferson University in Philadelphia, and colleagues from across the United States, sent ICDs with at least 70% battery life to India where the devices were cleaned, sterilized, and re-implanted in 40 patients who were at risk of life-threatening arrhythmias, but could not afford the $25,000 price tag for a new device.

During 2 years of follow-up, 35% of patients received appropriate shocks from their ICDs, and no infections were observed, Dr. Pavri reported at the scientific sessions of the American Heart Association.

Five patients received a second recycled device, including one in as little as a year. While some may consider this an unacceptable life span for a device, Dr. Pavri pointed out that during the life of the first device the patient received as many as 50 life-saving shocks for a condition known as VF storm.

“I have stacks of letters from patients and from family members of these patients expressing their gratitude for having sent them what is basically our trash,” he said in an interview.

Dr. Pavri said the idea to recycle ICDs was hatched over a decade ago by physicians who wanted to provide the life-saving devices, earmarked for the trash or return to the manufacturer, to patients in need in their native countries. While the donated devices are removed for upgrade or infection, Dr. Pavri said he can foresee eventually reaching out to funeral homes for post-mortem device retrieval.

“I would like to see this effort grow, but I emphasis that it has to remain a charitable effort,” he said. “The moment it becomes commercially slanted, the purpose will have been defeated.”

Patients and physicians interested in donating a defibrillator can contact Dr. Pavri at behzad.pavri@jefferson.edu.

—Patrice Wendling (on Twitter @pwendl)

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Filed under Cardiovascular Medicine, Drug And Device Safety, Emergency Medicine, Family Medicine, Hospital and Critical Care Medicine, IMNG, Internal Medicine, Practice Trends, Primary care, Surgery, Thoracic Surgery

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