Importantly, the paper does not seek to position patient care or patient safety against sustainability. On the contrary, the authors emphasise that any changes must preserve the effectiveness and safety of patient treatment. At the same time, they underline the need to adapt existing practices in order to prepare for future environmental, economic, and healthcare system constraints.
Why Electrophysiology Is in Focus
Electrophysiology is a growing, highly specialised field that is also particularly material-intensive. Many procedures rely on high-tech products, rare metals, complex polymers, and a large number of single-use materials.
Two key aspects are relevant here. Firstly, emissions and waste are generated through the use and disposal of medical devices. Secondly, fragile supply chains, scarce raw materials, and international dependencies may in the long term also affect the availability of critical medical products.
Remanufacturing as a potential building block
One key proposed solution is the remanufacturing or reprocessing of single-use medical devices. The authors clearly distinguish between remanufacturing and recycling: recycling involves breaking down a product into its components for use in new products. Remanufacturing, by contrast, refers to the reprocessing of a device originally labelled for single use through cleaning, testing, and re-sterilisation, enabling its safe reuse.
The paper identifies remanufacturing as a potential lever to reduce the environmental impact of electrophysiological procedures while also offering economic benefits. At the same time, the authors stress that remanufacturing must only be carried out under strict regulatory requirements to ensure the safety, performance, and quality of the devices. In the EU, remanufacturing and reprocessing are regulated under the MDR, which sets out requirements for quality management, technical documentation, post-market surveillance, and accountability.
Sustainability requires more than a single measure
A more sustainable electrophysiology practice cannot be achieved through a single intervention. It requires coordinated action among multiple stakeholders, including policymakers, regulators, manufacturers, professional societies, hospitals, and end users.
Proposed areas of action range from prevention and more efficient treatment strategies to the reduction of unnecessary materials, reprocessing, eco-design, interoperability, and the integration of environmental criteria into procurement decisions. Collaboration between hospitals, professional societies, and industry is also identified as a key lever for implementing more sustainable solutions in practice.
From ambition to implementation
A key message of the paper is that sustainability in electrophysiology is not an optional add-on but a future imperative. Remanufacturing can play an important role in this context, provided it is carried out with assured quality, regulatory compliance, and a clear focus on patient safety.
For healthcare systems, this means circular models should not begin only at the end of a product’s life. Instead, the entire life cycle of medical devices must be consideredfrom procurement and use to return and reprocessing, and ultimately, recycling where reuse is no longer possible. This holistic perspective can help conserve resources, control costs, and improve the long-term resilience of healthcare delivery.
