Expérience du Sénégal sur les pacemakers reconditionnés : à propos de 161 patients au centre hospitalo-universitaire Aristide Le Dantec

Introduction

The reuse pacemakers is a beneficial technique for patients in countries with a low economic standard of living where health care is almost non-existent. We offered to share the experience of Senegal on the reconditioning of pacemakers.

Methodology

We conducted a retrospective study over a period from January 2015 to December 2020 including all patients who benefited from a reconditioned pacemaker for primary implantation or reimplantation. The criteria for reconditioning pacemakers are the absence of dysfunction or damage and a residual battery life of more than 5 years of the pacemaker. Refurbished pacemakers are acquired either from deceased families or from extraction centers. Sterilization is carried out using phenoxypropanol + benzalkonium chloride solution, 70% ethanol and ethylene oxide.

Results

We collected 161 patients during the study period, including 77 men (48%) and 84 women (52%), i.e. a M/F sex ratio of 0.94. The average age of the population was 65 years. Functional symptomatology was dominated by syncope in 54%. Electrocardiographically, 72% of patients were in complete atrioventricular block. A primary implantation was noted in 91.5% of patients. The vascular approach most used during implantation was cephalic in 49.5% of cases. In our series, we noted that 58% of patients had benefited from temporary stimulation before implantation. At implantation, single-chamber stimulation was used in 60% of patients and 46.5% of patients had programming in VVI mode. We had 5.5% major complications with 3% box infection occurring between 3 and 6 months post-implantation and 2.5% pacemaker syndrome. We noted 1 case of death linked to underlying heart disease.

Conclusion

Reconditioning of cardiac pacemakers is a safe and beneficial therapeutic strategy for patients. In Senegal, reconditioning has shown satisfactory results. In our countries this technique can be an alternative for certain patients.