BACKGROUND: Catheter ablation of accessory atrioventricular (AV) connections has been demonstrated to be effective in more than 85% of patients. One of the risks of this procedure is radiation exposure during the fluoroscopic imaging necessary to guide catheter manipulation. The objective of the present study was to measure the radiation received by patients and physicians during radiofrequency catheter ablation and to estimate the resultant somatic and genetic risks. METHODS AND RESULTS: Radiation exposure to patients and physicians was measured during attempts at radiofrequency catheter ablation of accessory AV connections in 31 consecutive patients. Radiation exposure was measured using thermoluminescent sensors placed on the patient and on the physician. Somatic and genetic risks were estimated based on the radiation levels recorded using these sensors. The durations of fluoroscopy and of the catheter ablation procedure were recorded for each patient. Catheter ablation was successful in 28 of 31 patients (90%). Mean +/- SD duration of fluoroscopy was 44 +/- 40 minutes. The largest patient radiation dose was measured over the ninth vertebral body posteriorly (median, 7.26 rem [roentgen equivalents man]; range, 0.31-135.7 rem). Median radiation dose to the thyroid was 0.46 rem (range, 0.06-7.26 rem), and median radiation dose to the posterior iliac crest was 2.43 rem (range, 0.01-8.3 rem). The greatest radiation dose to the operator was recorded at the left hand (99 mrem). Mean radiation dose to the operator's eyes was 28 mrem. CONCLUSIONS: Radiofrequency catheter ablation of accessory AV connections may result in significant radiation exposure to the patient and to the physician. Each hour of fluoroscopic imaging is associated with a lifetime risk of developing a fatal malignancy of 0.1% and a risk of a genetic defect of 20 per 1 million births. Although these risks must be recognized, they are relatively small compared with the risks associated with alternate approaches to management, including no therapy, antiarrhythmic drug therapy, and surgery.
BACKGROUND: Catheter ablation of accessory atrioventricular (AV) connections has been demonstrated to be effective in more than 85% of patients. One of the risks of this procedure is radiation exposure during the fluoroscopic imaging necessary to guide catheter manipulation. The objective of the present study was to measure the radiation received by patients and physicians during radiofrequency catheter ablation and to estimate the resultant somatic and genetic risks. METHODS AND RESULTS: Radiation exposure to patients and physicians was measured during attempts at radiofrequency catheter ablation of accessory AV connections in 31 consecutive patients. Radiation exposure was measured using thermoluminescent sensors placed on the patient and on the physician. Somatic and genetic risks were estimated based on the radiation levels recorded using these sensors. The durations of fluoroscopy and of the catheter ablation procedure were recorded for each patient. Catheter ablation was successful in 28 of 31 patients (90%). Mean +/- SD duration of fluoroscopy was 44 +/- 40 minutes. The largest patient radiation dose was measured over the ninth vertebral body posteriorly (median, 7.26 rem [roentgen equivalents man]; range, 0.31-135.7 rem). Median radiation dose to the thyroid was 0.46 rem (range, 0.06-7.26 rem), and median radiation dose to the posterior iliac crest was 2.43 rem (range, 0.01-8.3 rem). The greatest radiation dose to the operator was recorded at the left hand (99 mrem). Mean radiation dose to the operator's eyes was 28 mrem. CONCLUSIONS: Radiofrequency catheter ablation of accessory AV connections may result in significant radiation exposure to the patient and to the physician. Each hour of fluoroscopic imaging is associated with a lifetime risk of developing a fatal malignancy of 0.1% and a risk of a genetic defect of 20 per 1 million births. Although these risks must be recognized, they are relatively small compared with the risks associated with alternate approaches to management, including no therapy, antiarrhythmic drug therapy, and surgery.
Authors: R M Campbell; M J Strieper; P A Frias; G Jeager; G Balfour; L Costello; K M Sullivan Journal: Pediatr Cardiol Date: 2005 Jan-Feb Impact factor: 1.655
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: Xiao Kui Li; James Pemberton; Kai Thomenius; Aaron Dentinger; Robert I Lowe; Muhammad Ashraf; K Kirk Shung; Raymond Chia; Douglas N Stephens; Matthew O'Donnell; Aman Mahajan; Seshadri Balaji; Kalyanam Shivkumar; David J Sahn Journal: J Ultrasound Med Date: 2007-11 Impact factor: 2.153
Authors: David E Haines; Salwa Beheiry; Joseph G Akar; Janice L Baker; Doug Beinborn; John F Beshai; Neil Brysiewicz; Christine Chiu-Man; Kathryn K Collins; Matthew Dare; Kenneth Fetterly; John D Fisher; Richard Hongo; Samuel Irefin; John Lopez; John M Miller; James C Perry; David J Slotwiner; Gery F Tomassoni; Esther Weiss Journal: Heart Rhythm Date: 2014-05-07 Impact factor: 6.343
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: Kevin A Wunderle; Mina K Chung; Sripriya Rayadurgam; Mark A Miller; Nancy A Obuchowski; Bruce D Lindsay Journal: J Interv Card Electrophysiol Date: 2018-10-02 Impact factor: 1.900
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