Harvard Heart Letter

Recycling effort keeps hearts ticking

What happens to a perfectly functioning pacemaker or implantable cardioverter-defibrillator (ICD) when its owner dies? Some end up in the grave. Others are removed in a funeral home so they won't explode during cremation, and then sit in a drawer or are discarded as medical waste. A few get new life when they are cleaned, sterilized, and implanted in someone in a low-income country who could never have afforded such a device.

Over the years, ad-hoc programs have recycled a small number of pacemakers and ICDs for use in low-income countries. Now an ambitious program aims to expand the number of devices that will have an afterlife. Project My Heart–Your Heart is a collaboration between the state of Michigan's citizens, physicians, and funeral directors, along with the University of Michigan Cardiovascular Center and World Medical Relief, a nonprofit organization that distributes donated medical goods in low-income countries. The group plans to work with a hospital in Manila and one in Hanoi, both of which have met the project's strict standards as implant centers. Recipients of the donated devices would not be charged for them.

In an article in the journal Circulation describing the project, Dr. Kim Eagle and his colleagues estimate that more than one million people with pacemakers or ICDs are cremated each year. If even one-quarter of their devices could be safely recycled, it would give a new lease on life for thousands of people who would ordinarily have little or no chance of getting a pacemaker or ICD.

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