Heart to Heart: a humanitarian project that gives a second life

This article is adapted from the sixth edition of the Foundation’s magazine.

By reusing still-functional pacemakers and defibrillators, the Heart to Heart project provides access to specialized care in areas of the world with limited treatment options while helping local teams gain expertise and build clinical independence.

While some regions in the world have very limited access to pacemakers and defibrillators, here in Canada some removed devices have considerable remaining service life. Heart to Heart was born as a way to offset this imbalance. Although these devices aren’t reused in Canada due to current standards, science has confirmed that doing so is completely safe. In a 2020 study published in the New England Journal of Medicine, co-authors Thomas Khairy and MHI cardiologist and electrophysiologist Paul Khairy demonstrated that the infection and mortality rates associated with resterilized devices were comparable with the rates of new devices. Since the project’s inception, pacemakers and defibrillators have been safely collected, refurbished, and redistributed to partner hospitals around the world.

After a slowdown during the pandemic, the project has gained new momentum. Initially led by Marie-Andrée Lupien, a medical electrophysiology technologist at the MHI, and Dr. Khairy, Heart to Heart has since been taken over by Catherine Harnois, Head of the Interventional Electrophysiology Laboratories and the Pacemaker Clinic at the MHI. The project’s current goal is to carry out two international missions per year.

In 2025, with support from the Foundation and Sainte-Justine au cœur du monde, Dr. Blandine Mondésert went on two missions to Abidjan, Côte d’Ivoire, with Cynthia Lauzon, a medical electrophysiology technologist, and Lucie Costentin, a hemodynamics nurse. The MHI joined CHU Sainte-Justine’s mission to the country to treat adults. The goal was to complement the region’s existing pediatric expertise so that teams could deliver more comprehensive care to Côte d’Ivoire patients.

A cardiologist who studied at the Université de Grenoble, Dr. Mondésert is also an electrophysiology specialist. Since 2014, she has been working at the Montreal Heart Institute on heart arrhythmia, new technologies for pacemakers and implantable defibrillators, and congenital heart disease in adults. This trip to Abidjan was not her first humanitarian mission, as she had visited other places such as Aswan, Egypt, some years previously. For her, contributing expertise in places where needs are great reveals a whole new perspective on her work. She said that this experience has stayed with her since she came back, as she feels more grounded and calmer in her daily life.

She is convinced Heart to Heart addresses a dire reality: “In Canada, we wouldn’t think twice about implanting a pacemaker in an emergency. Over there, cost is the first question that overrides any care they provide. I have seen patients be discharged from hospital without the device they need. If we can at least help families who can’t afford this treatment, we are already doing a great deal.”

A key component of the Heart to Heart program is training for local teams. In Côte d’Ivoire, Dr. Mondésert has seen how much local care teams strive to progress, adopt new practices, and develop sustainable expertise.

For her, sharing knowledge is the obvious thing to do. For example, on a previous mission to Egypt, she brought equipment to extract leads, pacemakers, and implantable defibrillators and performed procedures with the local team. She also gave them extra equipment before she left. A week later, she received a message from the doctors about how proud they were to have performed an extraction to the letter of her instructions with the equipment she gave them. Mission accomplished.

To expand the project across West Africa, the next step is to acquire a hydrogen peroxide low-temperature sterilizer, which is an essential piece of sterilization equipment.

For Dr. Mondésert, these missions give her a new frame of mind. “Over there, you don’t feel the pressure to perform. This lets you put things into perspective. And when you share knowledge, you always learn something new yourself.” 

“Helping local teams become independent, seeing patients who were treated on previous missions, and measuring the concrete impact of our work: this is what makes Heart to Heart so meaningful,” said Dr. Mondésert. Exploratory missions to Bouaké, Côte d’Ivoire, and Dakar, Senegal, are also being considered to open up other partnership opportunities for MHI teams. Heart to Heart has continued to be deployed with support from the Foundation with the aim of broadening its impact.

If Blandine’s heart could speak, here’s what it would say: 

“When you see gratitude in the eyes of patients, you can tell that your help changes everything, as they have a chance to keep living. These moments give you a real sense of accomplishment.”