Reducing radiation exposure in the electrophysiology laboratory: it is more than just fluoroscopy times!
Pacing Clin Electrophysiol
; 38(1): 136-45, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25486987
ABSTRACT
BACKGROUND:
To exposure in patients undergoing cardiac electrophysiology (EP) ablation. This included the use of a "very low" dose protocol, and the impact of angulations and patient body mass index (BMI) on radiation dose as a mean to reduce exposure.METHODS:
A total of 212 retrospective patient data sets were collected during EP ablation procedures on a biplane fluoroscopy system. Dose metrics were computed based on dose-area product (DAP) measured by the system for each x-ray acquisition.RESULTS:
Dose baselines of different ablation procedures were established as DAP and DAP per hour, with respect to patient BMI. The use of a "very low dose" protocol reduced exposure by 62% while providing adequate image quality. With approximate left anterior oblique (LAO) 50° and right anterior oblique (RAO) 30°, DAP and DAP rate were significantly higher in LAO compared to RAO (11.2 [4.8-25.3] Gy · cm(2) vs 5.28 [2.9-11.1] Gy · cm(2) and 74.0 [38.2-136.1] Gy · cm(2)/h vs 25.0 [16.4-44.1] Gy · cm(2)/h, respectively; P < 0.001). DAP and DAP rate were also significantly higher in patients with BMI > 30 vs BMI ≤ 30 (34.2 [22.3-58.7] Gy · cm(2) vs 12.4 [6.0-26.9] Gy · cm(2) and 84.9 [68.1-120.4] Gy · cm(2)/h vs 34.2 [21.7-52.9] Gy · cm(2)/h, respectively; P < 0.001).CONCLUSION:
Protocol setting, system angulation, and BMI, in particular, wider angulation in LAO compared to RAO plane, exposes patients to significant higher radiation doses. Obese patients in standard LAO plane receive six times the radiation dose of nonobese patients in RAO.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doses de Radiação
/
Fluoroscopia
/
Ablação por Cateter
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Israel