Pacemaker Reuse for Veterinary Patients: A CRM Rep Shares Her Story

In this article, Annette Akers, who has an extensive background working in the medical device industry, discusses how her experience in EP recently hit home.

In early 2015, I walked in the door of my apartment and as usual my 11-year-old Shih Tzu, Milo, greeted me at the door. At first, everything appeared to be normal, but I noticed his demeanor changing. He slowly lost consciousness and became unresponsive, falling to the floor. He recovered in less than a minute and everything returned to normal. I was certain it was a seizure but without a postictal state; his vet believed it was cardiac related. 

Over the next few months the episodes were happening more frequently, and he became increasingly lethargic during walks. Therefore, his vet scheduled an appointment with the veterinary cardiologist for an echocardiogram and a heart monitor. The 24-hour monitor (fitted specifically for animals) caught intermittent third-degree heart block, which was causing his syncope. Milo’s recorded escape rhythm was 27 bpm; a pacemaker was recommended. As a former CRM representative for St. Jude Medical, I was comfortable with the procedure and technology but was concerned about the cost, knowing that pacemakers are expensive devices. 

Pacemaker implantation in dogs is not unusual. The first pacemaker in a canine was implanted in 1968, and the procedure has increased in popularity over the years as pacemakers have become more available and financially feasible to pet owners. This is due to the generosity of CRM companies donating expired pacemakers labeled unsuitable for human use once battery life begins to deteriorate. The donated pacemakers and leads are received by an organization called CanPacers (Companion Animal Pacemaker Registry and Repository, www.canpacers.org), founded in 1991. The nonprofit organization then sells the devices to implanting veterinarians and hospitals for a fraction of the cost of a brand new pacemaker. A generator and lead cost $500, according to their website. Insertable loop recorders are also available for $100 each. All proceeds from the sale of the devices are used to fund cardiology resident research projects, leading to improved understanding of heart disease in animals. 

The pacemaker implant for dogs is similar to a human implant. Procedure time is approximately one hour, and an overnight hospital stay is required to reduce any chance of lead dislodgment. A small incision is made at the neck, and the lead is inserted transvenously through the jugular vein. An x-ray is usually performed the following day to ensure the lead has not moved, and a return visit is scheduled the following week for an interrogation and wound check. Routine interrogations are recommended every 3 months the first year, and reduced to once a year thereafter. 

Cardiology veterinarian Dr. Dennis Trafny implanted Milo’s VVI pacemaker at the Animal Medical Center in New York City. Dr. Trafny is one of approximately 250 cardiology vets trained to perform the procedure. Around 200 or more pacemakers are donated every year, but the demand is much greater. Veterinary hospitals and implanting cardiologists are encouraged to purchase more than one pacemaker at a time since it’s unknown when they will be able to purchase another due to an extremely low inventory. CanPacers keeps a waiting list, and can assist vets and hospitals in locating unused pacemakers and leads when emergencies arise. 

It’s been three weeks since Milo received his pacemaker, and the improvement in his activity level is extraordinary. He is back to his jovial self, and I am grateful for his new lease on life. I am very appreciative that I was able to afford this lifesaving option due to the donations of the CRM companies. 

Medical device companies donating expired devices is a way of honoring all the animals that play a key role and who have sacrificed in the development of these technologies. This article was written to celebrate and thank man’s best friend in giving life to my best friend.