Cardiovascular implantable electronic device function and longevity at autopsy: an underestimated resource

Worldwide pacemaker and defibrillator reuse: Systematic review and meta‐analysis of contemporary trials

“…This regulatory climate persists even though 87% of both device patients and device physicians surveyed in the United States are willing to donate their devices postmortem to help indigent patients in other nations . In fact, the majority of American device patients in the modern era die with pacemakers and defibrillators that are functional and have >7 years battery longevity on average . Unfortunately, such devices are much more likely to be discarded by funeral homes and crematoriums as “medical waste.” Consequently, the task of transforming our first world medical waste into life‐saving device therapy has to date fallen upon ad hoc medical volunteer initiatives and international charitable organizations such as Stimubanque (Paris, France), World Medical Relief (Detroit, MI, USA), and Pace4Life (London, United Kingdom).…”

“…5,34 In fact, the majority of American device patients in the modern era die with pacemakers and defibrillators that are functional and have >7 years battery longevity on average. 35 Unfortunately, such devices are much more likely to be discarded by funeral homes and crematoriums as "medical waste." 36 included studies in which more complex devices (CRT and implantable cardioverter-defibrillators) were used.…”

Postmortem Analysis of Electrogram Records from an Implantable Cardioverter‐Defibrillator (ICD) in the Reconstruction of a Road Traffic Accident

“…Thanks to the ability of ICDs to store information about incidents of arrhythmia and interventions made by the device, the relationship between these events and the timing of death can be determined, allowing the course of the event leading to death to be established . This paper presents a case in which a postmortem analysis of ICD records showed that immediately before the accident, the driver of the car suffered from dangerous arrhythmia resulting in his loss of consciousness.…”

Barriers to pacemaker and ICD recycling

“…If a patient is upgraded from a pacemaker to a defibrillator, or to a defibrillator with additional lead(s), the original device is explanted and destroyed as medical waste even though there may be 5–10 years of battery life remaining . With available and proven re‐sterilization techniques, it is possible to refurbish and donate them for reuse outside our country.…”