Antiarrhythmia devices—pacemakers and implantable cardioverter-defibrillators (ICDs)—are expensive scarce world resources that are available to the majority of the population in the economic “haves” countries but rarely to those without means in the economic “have-nots” countries. Impoverished or developing nations implant what devices they can primarily for life-threatening atrioventricular block, often only in younger patients. 1 Mond H.G. Irwin M. Ector H. Proclemer A. The world survey of cardiac pacing and cardioverter-defibrillators: calendar year 2005 an International Cardiac Pacing and Electrophysiology Society (ICPES) project. Pacing Clin Electrophysiol. 2008; 31: 1202-1212 Crossref PubMed Scopus (122) Google Scholar ICDs, for any indications, are beyond their scope of practice for all but the richest minority. Generators, leads, and the technical knowledge to implant devices are often obtained through humanitarian assistance, for example, the Pacemaker Banks established under the direction of the philanthropic organization Heartbeat International. 2 Mond H.G. Mick W. Maniscalco B.S. Heartbeat International: making “poor” hearts beat better. Heart Rhythm. 2009; 6: 1538-1540 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar Physicians trained and working in first-world countries with ties to the developing nations assist in pacemaker implantation and follow-up. 3 Kantharia B. Patel S. Kulkarni G. et al. Reuse of explanted permanent pacemakers donated by funeral homes. Am J Cardiol. 2011; PubMed Google Scholar Generators are often donated by manufacturers to the humanitarian organizations, typically outright or at a markedly reduced cost. New devices approaching end of shelf life are commonly used. Despite these programs, available data show that pacemaker implant rates in developing countries are a fraction of that in first-world countries. 1 Mond H.G. Irwin M. Ector H. Proclemer A. The world survey of cardiac pacing and cardioverter-defibrillators: calendar year 2005 an International Cardiac Pacing and Electrophysiology Society (ICPES) project. Pacing Clin Electrophysiol. 2008; 31: 1202-1212 Crossref PubMed Scopus (122) Google Scholar Although difficult to quantify, there is certainly significant morbidity and mortality associated with limited access to pacemakers. 2 Mond H.G. Mick W. Maniscalco B.S. Heartbeat International: making “poor” hearts beat better. Heart Rhythm. 2009; 6: 1538-1540 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar One clear bottleneck is the limited supply of new pacemaker generators. Feasibility of postmortem device acquisition for potential reuse in underserved nationsHeart RhythmVol. 9Issue 2PreviewThe purpose of the present study was to examine the feasibility and efficacy of a program to acquire devices with adequate battery life from crematories and funeral homes for potential reutilization in underserved nations. Full-Text PDF Postmortem device reuseHeart RhythmVol. 9Issue 6PreviewIn the February issue of HeartRhythm, the article by Baman et al1 and the succeeding editorial commentary2 suggest that explanted pacemakers should be reused. Full-Text PDF