Alyesh Daniel, Pavri Behzad B, Choe William, Chandara Mam, Sani Mahmoud U, Phan Phong Dinh, Bonny Aime, Khairy Paul, Sinha Sunil K, Srivatsa Uma, Marine Joseph E, Eagle Kim, Crawford Thomas C, Lakkireddy Dhanunjaya, Sundaram Sri
South Denver Cardiology Associates, Littleton, Colorado.
Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Heart Rhythm O2. 2022 Dec 16;3(6Part B):799-806. doi: 10.1016/j.hroo.2022.08.006. eCollection 2022 Dec.
A nation's health and economic development are inextricably and synergistically connected. Stark differences exist between wealthy and developing nations in the use of cardiac implantable electronic devices (CIEDs). Cardiovascular disease is now the leading cause of death in low- and middle-income countries (LMIC), with a significant burden from rhythm-related diseases. As science, technology, education, and regulatory frameworks have improved, CIED recycling for exportation and reuse in LMIC has become possible and primed for widespread adoption. In our manuscript, we outline the science and regulatory pathways regarding CIED reuse. We propose a pathway to advance this technology that includes creating a task force to establish standards for CIED reuse, leveraging professional organizations in areas of need to foster the professional skills for CIED reuse, collaborating with regulatory agencies to create more efficient regulatory expectations and bring the concept to scale, and establishing a global CIED reuse registry for quality assurance and future science.
一个国家的健康与经济发展紧密相连且相互促进。在心脏植入式电子设备(CIED)的使用方面,富裕国家和发展中国家存在显著差异。心血管疾病如今是低收入和中等收入国家(LMIC)的主要死因,与节律相关疾病造成了沉重负担。随着科学、技术、教育和监管框架的改善,CIED回收以供出口并在LMIC中再利用已成为可能,且有望得到广泛应用。在我们的手稿中,我们概述了有关CIED再利用的科学和监管途径。我们提出了一条推进这项技术的途径,包括成立一个特别工作组来制定CIED再利用标准,在有需求的领域借助专业组织培养CIED再利用的专业技能,与监管机构合作以建立更高效的监管预期并推广这一概念,以及建立一个全球CIED再利用登记处,用于质量保证和未来科学研究。