Abstract
Nava et al (Circulation 2013;127:1177, PMID 2342610) prospectively assessed the reuse of pacemakers in a cohort of consecutive patients and a control group. Six hundred three consecutive patients were evaluated in a noninferiority study, including 307 patients receiving resterilized pacemakers and 296 patients receiving a new pacemaker. A composite end point of unexpected battery depletion, infection, and device dysfunction was analyzed. Eighty-five pacemakers had to be explanted: 31 (10.5%) in the control group and 54 (17.6%) in the study group (hazard ratio [HR] 1.68; P = .02). Forty-three reached the primary end point: 16 (5.5%) in the control group and 27 (7.2%) in the study group (HR 1.3; P = .794). Five (1.7%) new pacemakers and 11 (3.6%) resterilized pacemakers had unexpected battery depletion (HR 2.12; P = .116); 3.7% new pacemakers and 3.2% reused pacemakers had a procedure-related infection (HR 0.87; P = .46). The authors conclude that pacemaker reuse is feasible and safe option. Other than the expected shorter battery life, the reuse of pacemaker generators is not inferior to the use of new devices.
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