Background: As healthcare systems face increasing economic and ecological pressures, the reuse of medical devices in high-volume procedures is gaining importance. This study evaluated the safety and effectiveness of resterilized 8 mm gold tip non-irrigated radiofrequency (RF) ablation catheters for cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter.
Methods: We conducted a retrospective single-center study including 181 patients who underwent CTI ablation at the University Hospital Bonn between January 2017 and May 2019. Patients were grouped based on catheter usage: new catheters (n=67), catheters resterilized 1–3 times (n=77), and catheters resterilized more than 3 times (n=37, maximum 7 uses). All devices underwent standardized autoclave-based reprocessing. The primary endpoint was atrial flutter recurrence, assessed through routine ECGs at 3 months or follow-up via general practitioners. Patients without documented relapse were contacted at study end to confirm symptom-free status. Secondary endpoints included procedural parameters such as total ablation time, power delivery, and catheter tip temperature.
Results: Freedom from atrial flutter recurrence at 3 months was 93.4% for new catheters, 93.2% for catheters reused 1–3 times, and 93.5% for those reused more than 3 times. Long-term follow-up extended up to 2620 days, with no significant difference in recurrence-free survival between groups. Median recurrence-free intervals were 1962 days for new catheters, 1822 days for 1–3 reuses, and 1838 days for >3 reuses (p=0.59, log-rank test).
Procedural performance was also comparable across groups. Total ablation time averaged 484 ± 54 seconds for new catheters, 551 ± 44 seconds for 1–3 reuses, and 458 ± 44 seconds for >3 reuses (p=0.34). Average ablation power was 57.5 ± 1.1 W, 58.1 ± 0.8 W, and 58.6 ± 1.1 W, respectively (p=0.75). Mean catheter tip temperatures were 55.4 ± 0.9 °C for new catheters, 54.8 ± 0.9 °C for 1–3 reuses, and 54.3 ± 0.7 °C for >3 reuses (p=0.72). Additional periprocedural parameters, including resistance, average current, total procedure time, and time to bidirectional CTI block, did not differ significantly between groups.
Conclusions: Autoclave-based resterilization of 8 mm gold tip RF ablation catheters up to seven times does not negatively impact clinical outcomes or procedural performance in CTI ablation for typical atrial flutter. In high-volume electrophysiology practices, reusing catheters offers substantial economic and ecological advantages by reducing both material costs and medical waste. These findings support the integration of validated reuse protocols into sustainable, high-quality cardiac care.
