Patient Perceptions of Reprocessed Electrophysiology Catheters in a Public-Sector Cardiac Center: Cost and Waiting-Time Trade-Offs in a Low–Middle Income Country

Abstract

Objectives: This study aimed to assess patient perceptions toward the use of reprocessed EP catheters and, when deemed unacceptable, to evaluate their willingness to pay additional procedural costs for new catheters or to tolerate extended waiting times until new catheters became available. Methodology: We conducted a cross-sectional survey of 100 consecutive adult patients who underwent electrophysiology study (EPS) with or without catheter ablation for supraventricular tachycardia at a tertiary public cardiac center in Karachi, Pakistan. A structured questionnaire in the local language (Urdu) was administered post-procedure to evaluate perceptions regarding reprocessed catheters, willingness to pay additional costs for new catheters, and acceptable waiting periods for free-of-cost new catheters. Results: Among 100 participants (mean age 45.2 ± 14.0 years; 60% female), 57% reported that reprocessed catheters “can be used” if their physician was satisfied with safety, while 40% believed they “should not be used,” and 3% were uncertain. The most common concerns among those opposed were infection risk (77.5%), concerns regarding adequacy of reprocessing protocols (55%), and perceived inefficiency (42.5%). When presented with financial trade-offs, 41% preferred reprocessed catheters rather than making additional out-of-pocket payments. Only 2% were willing to pay the full cost of new catheters. Regarding waiting time, 65% preferred immediate use of reprocessed catheters rather than delaying treatment for new devices. Conclusion: Although a substantial proportion of patients expressed concerns regarding reuse, practical considerations including financial limitations and urgency of symptom relief, significantly influenced preferences. Clear communication regarding safety protocols and shared decision-making may enhance patient acceptance of reprocessed catheters while improving cost-effectiveness and access to electrophysiology services in resource-limited settings.