BACKGROUND: The purpose of this study was to determine the radiation exposure during catheter ablation of atrial fibrillation (AF) using the pulmonary vein (PV) approach. METHODS AND RESULTS: The study included 15 patients with AF and 5 patients each with atrial flutter and atrioventricular nodal reentrant tachycardia (AVNRT) who underwent fluoroscopically guided procedures on a biplane x-ray system operated at a low-frame pulsed fluoroscopy (7.5 frames per second). Radiation exposure was measured directly with 50 to 60 thermoluminescent dosimeters (TLDs). Peak skin doses (PSDs), effective radiation doses, and risk of fatal malignancies were all computed. Mean fluoroscopy durations for AF procedures were 67.8+/-21 minutes in the right anterior oblique (RAO) and 61.9+/-16.6 minutes in the left anterior oblique (LAO) projection, significantly different from that required for atrial flutter and AVNRT. The mean PSDs measured with the TLDs were 1.0+/-0.5 Gy in the RAO and 1.5+/-0.4 Gy in the LAO projection. The lifetime risk of excess fatal malignancies normalized to 60 minutes of fluoroscopy was 0.07% for women and 0.1% for men. CONCLUSIONS: The relatively small amounts of the patient's radiation exposure in this study, despite the prolonged fluoroscopy durations, can be attributed to the use of very-low-frame pulsed fluoroscopy, the avoidance of magnification, and optimal adjustments of the fluoroscopy exposure rates. The resulting lifetime risk of fatal malignancy is within the range previously reported for standard supraventricular arrhythmias.
BACKGROUND: The purpose of this study was to determine the radiation exposure during catheter ablation of atrial fibrillation (AF) using the pulmonary vein (PV) approach. METHODS AND RESULTS: The study included 15 patients with AF and 5 patients each with atrial flutter and atrioventricular nodal reentrant tachycardia (AVNRT) who underwent fluoroscopically guided procedures on a biplane x-ray system operated at a low-frame pulsed fluoroscopy (7.5 frames per second). Radiation exposure was measured directly with 50 to 60 thermoluminescent dosimeters (TLDs). Peak skin doses (PSDs), effective radiation doses, and risk of fatal malignancies were all computed. Mean fluoroscopy durations for AF procedures were 67.8+/-21 minutes in the right anterior oblique (RAO) and 61.9+/-16.6 minutes in the left anterior oblique (LAO) projection, significantly different from that required for atrial flutter and AVNRT. The mean PSDs measured with the TLDs were 1.0+/-0.5 Gy in the RAO and 1.5+/-0.4 Gy in the LAO projection. The lifetime risk of excess fatal malignancies normalized to 60 minutes of fluoroscopy was 0.07% for women and 0.1% for men. CONCLUSIONS: The relatively small amounts of the patient's radiation exposure in this study, despite the prolonged fluoroscopy durations, can be attributed to the use of very-low-frame pulsed fluoroscopy, the avoidance of magnification, and optimal adjustments of the fluoroscopy exposure rates. The resulting lifetime risk of fatal malignancy is within the range previously reported for standard supraventricular arrhythmias.
Authors: Wilson Kwong; Andrea L Neilson; Christine C Chiu; Gil J Gross; Robert M Hamilton; Luc Soucie; Elizabeth A Stephenson; Joel A Kirsh Journal: J Interv Card Electrophysiol Date: 2011-10-18 Impact factor: 1.900
Authors: Anil K Gehi; Igor Shuryak; Stephen Balter; Justin Vandermolen; Johanna M Meulepas; Ryan King; Neil D Mehta; David J Brenner; Andrew J Einstein Journal: JACC Clin Electrophysiol Date: 2017-10-16
Authors: John D Ferguson; Adam Helms; J Michael Mangrum; Srijoy Mahapatra; Pamela Mason; Ken Bilchick; George McDaniel; David Wiggins; John P DiMarco Journal: Circ Arrhythm Electrophysiol Date: 2009-12
Authors: David J Sahn; Douglas N Stephens; Jonathan M Cannata; K Shung; Omer Oralkan; Amin Nikoozadeh; B T Pierre Khuri-Yakub; Hien Nguyen; Peter Chen; Aaron M Dentinger; Douglas Wildes; Kai E Thomenius; Aman Mahajan; Kalyanam Shivkumar; Matthew O'Donnell Journal: Conf Proc IEEE Eng Med Biol Soc Date: 2009
Authors: Dhanunjaya Lakkireddy; George Nadzam; Atul Verma; Subramanya Prasad; Kay Ryschon; Luigi Di Biase; Mohammed Khan; David Burkhardt; Robert Schweikert; Andrea Natale Journal: J Interv Card Electrophysiol Date: 2008-11-06 Impact factor: 1.900
Authors: D N Stephens; J Cannata; Ruibin Liu; Jian Zhong Zhao; K K Shung; Hien Nguyen; R Chia; A Dentinger; D Wildes; K E Thomenius; A Mahajan; K Shivkumar; Kang Kim; M O'Donnell; A Nikoozadeh; O Oralkan; P T Khuri-Yakub; D J Sahn Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2008-07 Impact factor: 2.725