Jama Z.V., Chin A., Badri M., Mayosi B.M.
Cardiac Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa; College of Medicine, King Saudi Bin, Abdulaziz University for Medical Sciences, Riyadh, Saudi Arabia
Jama, Z.V., Cardiac Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa; Chin, A., Cardiac Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa; Badri, M., College of Medicine, King Saudi Bin, Abdulaziz University for Medical Sciences, Riyadh, Saudi Arabia; Mayosi, B.M., Cardiac Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa
Objectives: Little is known about the performance of re-used pacemakers and implantable cardioverter defibrillators (ICDs) in Africa. We sought to compare the risk of infection and the rate of malfunction of re-used pacemakers and ICDs with new devices implanted at Groote Schuur Hospital in Cape Town, South Africa. Methods: This was a retrospective case comparison study of the performance of re-used pacemakers and ICDs in comparison with new devices implanted at Groote Schuur Hospital over a 10-year period. The outcomes were incidence of device infection, device malfunction, early battery depletion, and device removal due to infection, malfunction, or early battery depletion. Results: Data for 126 devices implanted in 126 patients between 2003 and 2013 were analysed, of which 102 (81%) were pacemakers (51 re-used and 51 new) and 24 (19%) were ICDs (12 re-used and 12 new). There was no device infection, malfunction, early battery depletion or device removal in either the re-used or new pacemaker groups over the median follow up of 15.1 months [interquartile range (IQR), 1.3-36.24 months] for the re-used pacemakers, and 55.8 months (IQR, 20.3-77.8 months) for the new pacemakers. In the ICD group, no device infection occurred over a median follow up of 35.9 months (IQR, 17.0-70.9 months) for the re-used ICDs and 45.7 months (IQR, 37.6-53.7 months) for the new ICDs. One device delivered inappropriate shocks, which resolved without intervention and with no harm to the patient. This re-used ICD subsequently needed generator replacement 14 months later. In both the pacemaker and ICD groups, there were no procedure-non-related infections documented for the respective follow-up periods. Conclusion: No significant differences were found in performance between re-used and new pacemakers and ICDs with regard to infection rates, device malfunction, battery life and device removal for complications. Pacemaker and ICD re-use is feasible and safe and is a viable option for patients with bradyarrhythmias and tachyarrthythmias.
advanced cancer; aged; arthritis; Article; atherosclerosis; bacterial endocarditis; cancer mortality; cause of death; cerebrovascular accident; chronic obstructive lung disease; comorbidity; controlled study; dementia; device comparison; device malfunction; device removal; diabetic angiopathy; female; follow up; human; immobility; implantable cardioverter defibrillator; incidence; infection risk; leg amputation; major clinical study; male; medical device complication; methicillin resistant Staphylococcus aureus infection; outcome assessment; pacemaker; pacemaker implantation; recycling; retrospective study; sepsis; South Africa; supraventricular tachycardia