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Velagic V, Mugnai G, Prepolec I, Pasara V, Milinković A, Nekić A, Bogdanic JE, Posavec JP, Puljević D, de Asmundis C, Chierchia GB, Milicic D. Feasibility and safety of reprocessing of intracardiac echocardiography catheters for electrophysiology procedures - a large single center experience. Cardiovasc Ultrasound 2023; 21:20. [PMID: 37880719 PMCID: PMC10601175 DOI: 10.1186/s12947-023-00318-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE Intra-cardiac echocardiography (ICE) has become an important tool for catheter ablation. Adoption of ICE imaging is still limited because of its prohibitively high cost. Our aim was to study the safety and feasibility of ICE catheters reprocessing and its environmental and financial impact. METHODS This was a single center retrospective analysis of all consecutive electrophysiology procedures in which ICE catheters were used from 2015 to 2022. In total, 1128 patients were studied (70.6% male, mean age was 57.9 ± 13.2 years). The majority of procedures were related to atrial fibrillation ablation (84.6%). RESULTS For the whole cohort, 57 new ICE catheters were used. Consequently one catheter could be used for 19.8 procedures. New catheters were only used when the image obtained by reused probes was not satisfactory. There were no cases of ICE probe steering mechanism malfunction, no procedure related infections and no allergic reactions that could be attributed to the resterilization process. In total, there was 8.6% of complications not related to ICE imaging. Financially, ICE probe reprocessing resulted with 90% cost reduction (> 2 millions of Euros savings for the studied period) and 95% waste reduction (639.5 kg less, mostly non degradable waste was produced). CONCLUSION Our data suggests that ICE catheter reprocessing is feasible and safe. It seems that risk of infection is not increased. Significant economic and environmental savings could be achieved by ICE catheters reprocessing. Furthermore, ICE reprocessing could allow more extensive ICE usage resulting in safer procedures with a potential reduction of serious complications.
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Affiliation(s)
- Vedran Velagic
- University of Zagreb, School of Medicine, Zagreb, Croatia.
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia.
| | - Giacomo Mugnai
- Electrophysiology and Cardiac Pacing, Division of Cardiology, University Hospital of Verona, Verona, Italy
| | - Ivan Prepolec
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia
| | - Vedran Pasara
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia
| | - Anica Milinković
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia
| | - Andrija Nekić
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | | | | | - Davor Puljević
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia
| | | | | | - Davor Milicic
- University of Zagreb, School of Medicine, Zagreb, Croatia
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia
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Boussuge-Roze J, Boveda S, Mahida S, Anic A, Conte G, Chun JKR, Marijon E, Sacher F, Jais P. Current practices and expectations to reduce environmental impact of electrophysiology catheters: results from an EHRA/LIRYC European physician survey. Europace 2022; 24:1300-1306. [PMID: 35943366 DOI: 10.1093/europace/euac085] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 01/13/2023] Open
Abstract
The healthcare sector accounts for nearly 5% of global greenhouse gas emissions (GHG) and is a significant contributor to complex waste. Reducing the environmental impact of technology-heavy medical fields such as cardiac electrophysiology (EP) is a priority. The aim of this survey was to investigate the practice and expectations in European centres on EP catheters environmental sustainability. A 24-item online questionnaire on EP catheters sustainability was disseminated by the EHRA Scientific Initiatives Committee in collaboration with the Lyric Institute. A total of 278 physicians from 42 centres were polled; 62% were motivated to reduce the environmental impact of EP procedures. It was reported that 50% of mapping catheters and 53% of ablation catheters are usually discarded to medical waste, and only 20% and 14% of mapping and ablation catheters re-used. Yet, re-use of catheters was the most commonly cited potential sustainability solution (60% and 57% of physicians for mapping and ablation catheters, respectively). The majority of 69% currently discarded packaging. Reduced (42%) and reusable (39%) packaging also featured prominently as potential sustainable solutions. Lack of engagement from host institutions was the most commonly cited barrier to sustainable practices (59%). Complexity of the process and challenges to behavioral change were other commonly cited barriers (48% and 47%, respectively). The most commonly cited solutions towards more sustainable practices were regulatory changes (31%), education (19%), and product after-use recommendations (19%). In conclusion, EP physicians demonstrate high motivation towards sustainable practices. However, significant engagement and behavioural change, at local institution, regulatory and industry level is required before sustainable practices can be embedded into routine care.
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Affiliation(s)
- Julie Boussuge-Roze
- Electrophysiology and Heart Modelling institute, IHU Liryc, Univ. Bordeaux, INSERM, CRCTB, U 1045, Campus Xavier Arnozan - Avenue du Haut-Leveque, F-33600 Pessac, France
- CHU de Bordeaux, Department of Electrophysiology and Cardiac Stimulation, F-33000 Bordeaux, France
| | - Serge Boveda
- Clinique Pasteur, Heart Rhythm Department, Toulouse, France
- Universiteit Ziekenhuis Brussel - VUB, Brussels, Belgium
| | - Saagar Mahida
- Electrophysiology and Heart Modelling institute, IHU Liryc, Univ. Bordeaux, INSERM, CRCTB, U 1045, Campus Xavier Arnozan - Avenue du Haut-Leveque, F-33600 Pessac, France
- Department of Cardiac Electrophysiology, Liverpool Heart and Chest Hospital, NHS Trust, UK
| | - Ante Anic
- University Hospital Centre Split, Department for Cardiovascular diseases, Split, Croatia
| | - Giulio Conte
- Cardiology Department, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Julian K R Chun
- CCB, Cardiology, Med. Klinik III, Markuskrankenhaus, Frankfurt, Germany
| | - Eloi Marijon
- European Georges Pompidou Hospital and Paris City University, Cardiology Department, Paris, France
| | - Frederic Sacher
- Electrophysiology and Heart Modelling institute, IHU Liryc, Univ. Bordeaux, INSERM, CRCTB, U 1045, Campus Xavier Arnozan - Avenue du Haut-Leveque, F-33600 Pessac, France
- CHU de Bordeaux, Department of Electrophysiology and Cardiac Stimulation, F-33000 Bordeaux, France
| | - Pierre Jais
- Electrophysiology and Heart Modelling institute, IHU Liryc, Univ. Bordeaux, INSERM, CRCTB, U 1045, Campus Xavier Arnozan - Avenue du Haut-Leveque, F-33600 Pessac, France
- CHU de Bordeaux, Department of Electrophysiology and Cardiac Stimulation, F-33000 Bordeaux, France
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