Nursing Department I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Sarriena, Leioa, Spain.
BioCruces-Bizkaia Health Research Institute, Baracaldo, Spain.
J Interv Card Electrophysiol. 2023 Aug;66(5):1095-1101. doi: 10.1007/s10840-022-01304-y. Epub 2022 Jul 15.
Postmortem explanted cardiac implantable electronic devices (CIEDs) from developed countries could provide patients unable to afford new devices in low- and middle-income countries (LMIC) a treatment they lack. This study describes the preferences of electrophysiologists and device implanting cardiologists from Spain on the management of explanted CIEDs and opinions and concerns regarding reuse in LMIC.
A nationwide self-administered questionnaire was sent to members of the Spanish Rhythm Association (n = 1110), between December 2020 and January 2021.
Forty-two physician responses were obtained (response rate 5%). There was a strong preference to donate explanted devices for reuse in humans (61.9%) or animals (31%). The vast majority of the participants thought device reutilization was safe, ethical, and a reasonable alternative if a new device is not accessible. Moreover, they indicated they would be comfortable asking patients to consider post-mortem donation, and willing to implant post-mortem explanted and resterilized devices if they were unable to obtain new ones. 57.1% of respondents considered it would be beneficial for patients to have a document so they could reflect their wishes regarding device handling after their death. The most mentioned concerns regarding device reuse were malfunction (57.1%) and infection (54.8%).
The majority of respondents support reusable CIED donation to LMIC. It would be interesting to study the feasibility of a nationwide device reutilization program.
从发达国家取出的已植入心脏的可植入式电子设备（CIED）可以为那些无法负担新设备的低收入和中等收入国家（LMIC）的患者提供他们所缺乏的治疗。本研究描述了来自西班牙的电生理学家和心脏植入设备医生对处理已取出的 CIED 的偏好，以及他们对在 LMIC 中重复使用的意见和担忧。
在 2020 年 12 月至 2021 年 1 月期间，向西班牙心律协会的成员（n=1110）发送了一份全国性的自我管理问卷。
获得了 42 名医生的回复（回复率为 5%）。强烈倾向于将已取出的设备捐赠用于人类（61.9%）或动物（31%）的重复使用。绝大多数参与者认为设备的再利用是安全的、合乎道德的，而且如果无法获得新设备，这是一个合理的替代方案。此外，他们表示，他们会很乐意询问患者是否考虑死后捐赠，并且愿意植入死后取出和重新消毒的设备，如果他们无法获得新设备。57.1%的受访者认为，如果患者有一份文件，以便在死后能够反映他们对设备处理的意愿，这对患者是有益的。关于设备重复使用的最常见的担忧是故障（57.1%）和感染（54.8%）。
大多数受访者支持将可重复使用的 CIED 捐赠给 LMIC。研究全国性的设备再利用计划的可行性将是很有趣的。
