Background: Heartbeat International is a little-known 501(c)(3) charitable organization, which for the past 25 years has been responsible for the implantation and follow-up of cardiac implantable electronic devices in over 9000 indigent recipients in predominantly developing countries. Although the concept was founded in Guatemala over 30 years ago, it took the vision and drive of Dr. Henry D. McIntosh, M.D., M.A.C.C, to create Heartbeat International in 1984.
Discussion: The organization works through Pacemaker Banks established by local Rotary International chapters and other civic organizations in 24 countries over four continents and is dependent on the generosity of the implantable device manufacturers and teams of dedicated physicians and hospital personnel in the countries of operation. Since the vast majority of personnel are voluntary, 90 cents of every donated dollar directly supports the provision, implantation of devices, and follow-up care. Each US$500 provides a pacemaker to one needy patient. The organization's co-mission is also to educate and train implanting physicians in pacing and implantable cardioverter-defibrillator technology. The program remains dependent on the pacemaker manufacturers, who work in an environment of regulatory constraint and economic imperatives. With an ever growing demand for these devices, Heartbeat International will in the future need to increase its operating budget to purchase implantable inventory.