An estimated 1 million to 2 million people around the world die each year because they have no access to a pacemaker, an implanted device that uses electrical pulses to the heart to maintain a normal heartbeat.
One potential, largely untapped source of pacemakers for the world's poor could be the significant number of people in the U.S. who die with a still-functioning device - some 19 per cent of the deceased, according to one survey of morticians in Michigan and Illinois.
The majority of those are buried with the body or, if removed, thrown away as medical waste but a small percentage are donated to developing nations through charities.
"Implantation of donated permanent pacemakers can not only save lives but also improve quality of life of needy poor patients," wrote study leader Bharat Kantharia, of the University of Texas Health Science Center, in the American Journal of Cardiology.
Kantharia and his team collected 122 pacemakers, half of which had enough battery life left - more than three years - to be used again. They were partially sterilized, then sent to a hospital in Mumbai, India, where they were sterilized again and implanted in 53 heart patients.
New pacemakers in India cost $2,200 to $6,600, not including doctor and hospital fees or the cost of the wires connected to the pacemaker.
All of the patients survived the surgery and fared well immediately afterwards, with no cases of infection or pacemaker malfunctions over an average follow-up of nearly two years.
All but two of the 40 patients reported a marked improvement in their symptoms and quality of life. Four died, but their deaths were not linked to the pacemakers.
A number of significant hurdles remain. One of the biggest is simply getting pacemakers from the U.S. to impoverished patients who need them.
Another is the need for further safety studies.
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