It's getting worse. Last Monday, our Biosense Webster rep informed us that the company would not be able to support a Ventricular Tachycardia ablation procedure, because we were planning on using a reprocessed DecaNav catheter, which is used for mapping and usually without fully utilizing its navigational functionality. In other words: This is not a sensor-enabled catheter, neither is it a catheter that could in any way be compromised by reprocessing and re-use. I have heard from colleagues that Biosense Webster reps in other areas have upped the ante as well and simply shut down support if ANY reprocessed catheter is used.

As mentioned, fully utilizing reprocessed catheters in an electrophysiology procedure could reduce our costs by as much as $3,000. We are blocked from realizing $2,000 of these savings, due to a non-sensical rationale about sensor-enabled catheters. Now, it appears that we will be losing the $1,000 in savings from non-sensor-enabled catheters as well – with absolutely NO rationale. Other than, “we said so – and your doctors depend on us.”


There are two reasons why this is just not going to work. One has to do with EP procedure economics, and one comes down to the resilience of the supply chain.

Firstly, every few years we take price increases from Biosense Webster on “new generation” technologies and software solutions. We do this because Biosense Webster is a leader in EP technology and truly provide fantastic options for our doctors. However, as device costs go up, procedure profits go down and threaten the economic feasibility of our EP labs. Thankfully, safe re-use solutions are available to remedy this while utilizing Biosense Webster’s new technology, but if we cannot access them, in the end we cannot offer the best technologies to our doctors.

The math just doesn’t work, and I am actually baffled that Biosense Webster doesn’t understand that our utilization of their best technology, their leadership in the area, DEPENDS on our re-use of their devices. Using reprocessed devices in our procedures is safe and responsible. It allows us to address modern-day economic realities as well as the need for healthcare to become more environmentally sustainable. I would like to see Biosense Webster become more of a partner in this, but up to this point, they have fought it rather than becoming the partner I think they should be.

Secondly, the post-pandemic reality of the EP lab means supply chain shortages are a real thing that effectively restrict our ability to do procedures. There have been many situations lately where we haven’t been able to get new devices for our procedures. Thankfully we have reprocessed devices that we can rely on to actually get through our cases. Reprocessing does help to make our supplies more reliable; the practice helps us stay in business. This is something that is not discussed enough: When we can re-use devices through an FDA regulated process, this becomes a life-saver in our day-to-day operations – like my situation this Monday. How am I supposed to go to my doctor and say, “you can’t do your procedure because I am lacking a device,” when I have five reprocessed devices on the shelf that will do the job just fine? Biosense Webster, your policy here is not doing your honor, and your position is not going to be successful. We need reprocessed devices.

I fully expect my colleagues across the nation to say “enough is enough” if Biosense Webster continues to reduce meaningful savings. Eventually labs like mine will seek partnerships with other suppliers to be able to access the benefits of resilience, cost savings and environmental benefits offered by safe, FDA controlled reprocessing.

About the author: MarkAnthony Manganello is a former registered cardiovascular invasive specialist at Bon Secours Health System.
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