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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: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Duncker D, Svetlosak M, Guerra F, Nagy KV, Vanduynhoven P, Mikhaylov EN, Kosiuk J. Reprocessing of electrophysiology material in EHRA countries: an EHRA Young EP survey. Europace 2021; 23:479-485. [PMID: 33083819 DOI: 10.1093/europace/euaa250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/20/2020] [Indexed: 11/12/2022] Open
Abstract
Data on reprocessing of electrophysiology (EP) materials are sparse. Reprocessing of catheters and other materials in daily routine varies through countries and may depend on specific material characteristics, supplier, or federal law. The aim of this study was to collect data on reprocessing usage through EHRA countries. An online survey consisting of 27 questions was distributed to EHRA Young EP members and members of national EP working groups. Two hundred and two participants from 34 EHRA countries completed the survey. One hundred and seven respondents (53.0%) reported having used and using reprocessed EP material, 30 (14.9%) respondents have used reprocessed EP material in the past but not at the time of the survey, 65 (32.2%) had never used reprocessed EP material. The most reprocessed EP materials include cables (70%), diagnostic EP catheters with deflectable (64%) or fixed curve (63%), non-irrigated ablation catheters (51%), and other conventional diagnostic catheters (41%). The most durable material was diagnostic EP catheters with a fixed curve (61%), the most sensitive material was ablation catheters with contact force sensors (21%). Important benefits were seen in reducing costs for the providing hospital (65%) and the healthcare provider (42%) and making EP procedures available for a greater number of patients (42%). Main concerns were on quality aspects (58%), contamination (52%), and loss of precision (47%). Reprocessing of EP materials is heterogeneously managed among EHRA countries. The present survey shows that European electrophysiologists consider the use of reprocessed EP material as generally safe and cost-effective.
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Affiliation(s)
- David Duncker
- Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Martin Svetlosak
- Department for Arrhythmias and Cardiostimulation, National Institute for Cardiovascular Diseases, Pod Krásnou hôrkou 1, 83348 Bratislava, Slovakia
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, University Hospital 'Ospedali Riuniti Umberto I- Lancisi - Salesi', Marche Polytechnic University, via Conca 71, 60126 Ancona, Italy
| | | | | | - Evgeny N Mikhaylov
- Arrhythmia Department, Neuromodulation Laboratory, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation.,Department of Bioengineering Systems, Saint-Petersburg Electrotechnical University 'LETI', Saint Petersburg, Russian Federation
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