Task Shifting in Cardiac Ablations Compared With Percutaneous Coronary Interventions: The Japanese Circulation...

As part of work-style reform for physicians, task shifting to non-physician healthcare professionals has been promoted in Japan. We previously reported task shifting results for percutaneous coronary interventions (PCI), but the status in arrhythmia treatment remains unclear.

This subanalysis of a survey conducted by the Japanese Circulation Society Chugoku-Shikoku Branch examined task shifting in facilities performing both cardiac ablations and PCIs. A 30-item questionnaire was sent in March 2024 to 93 facilities managing acute coronary syndrome. Among 81 responding facilities (87.1% response rate), 51 performed cardiac ablations. Approximately 40% had only 1 ablation operator. The engagement rate as second operators was lower for ablations than for PCI (21.6% vs. 29.4%, P<0.001). Task shifting implementation showed no significant difference based on ablation operator numbers (N=1: 30.0% vs. N≥2: 16.1%, P=0.304), whereas facilities with fewer PCI operators had higher task shifting rates (P=0.026). Clinical engineers were the predominant profession in task shifting for both procedures.

Task shifting of sterile procedures was limited in ablation facilities compared with PCI, reflecting the procedural characteristics such as single-operator feasibility and mapping-intensive workflows. With substantial workload demands, continued collaboration with highly specialized medical staff is essential, along with appropriate incentives and attention to work-life balance.