In a recent article in Nature Reviews—Cardiology entitled Environmental sustainability in cardiology: reducing the carbon footprint of the catheterization laboratory (lab), investigators discussed the significant impact of cardiac electrophysiology catheterization labs on climate change. Ground-breaking technical and scientific innovations in cardiac electrophysiology have significantly reduced the morbidity and mortality of cardiac arrythmias; however, the authors explained, catheter ablation benefits are now gained at too high a cost to the environment.
Although advancements in cardiac catheterization have reduced the incidence and severity of arrhythmias, globally the demand for ablations has increased exponentially. Consequently, cardiac catheters now comprise almost 40% of the global health sector’s carbon footprint. In fact, the health sector emissions represent almost 5% of total global greenhouse gas emissions.1 For example, single-use medical devices for atrial fibrillation ablation alone create over 125 tonnes of carbon dioxide (CO2) daily.1 Thus, this article declared, tackling the environmental unsustainability of cardiac catheterization to reduce worldwide emissions to net-zero by 2050, must become a priority.
Employing circular economy approaches to decrease the environmental impact of cardiac catheterization
Cardiac catheterizations use environmentally damaging materials, such as rare metals in catheter electrodes that rely on high carbon-intensive supply chains. Moreover, general anesthesia, which offers advantages over conscious sedation, accounts for 25% of a catheterization’s carbon footprint. The authors asserted, the challenge of decreasing the environmental impact requires innovation and meaningful determination on a global scale.
A recent European Heart Rhythm Association survey revealed 62% of physicians are willing to use more sustainable practices. In particular through ‘circular-economy’ approaches.1 Such approaches involve adjusting ‘take-make-dispose’ policies (and supply chains that produce >70% of healthcare emissions) to environmentally sustainable ‘reduce-reuse-recycle’ procedures worldwide.
As a circular economy expert described in the article, “reuse when you can, and recycle when you can’t reuse.” Therefore, given the growing scarcity of resources (and supply chain issues), innovations in repackaging and/or ‘reusing’ electrophysiology catheters need to have higher priority. However, ‘recycling’ complex medical devices remains illegal in many countries. Therefore, political, healthcare, and physician engagement must be encouraged to advocate for these changes. The authors conclude, cardiac catheterization laboratories remain significant contributors to the global health sector’s carbon footprint and to climate change. Therefore, barriers to environmentally sustainable ablation procedures must be addressed. Using circular-economy approaches may help to minimize their negative impacts on the planet while improving catheterization processes and costs.
Author: Saskia van Tetering
Original article: Boussuge-Roze J, Duchateau J, Bessiere F, Sacher F, and Jaïs P. Environmental sustainability in cardiology: reducing the carbon footprint of the catheterization laboratory. Nature Reviews Cardiol. 2023;20:69-70.