RADIATION SAFETY IN THE CARDIAC-CATHETERIZATION LABORATORY

Over the years, permissible radiation exposure of operators working wi th x-ray equipment has become progressively reduced. The number of car diac catheterizations and related interventional procedures has increa sed and the procedures have become more prolonged. The patient receive s relatively infrequent primary radiation while the operator receives frequent but mainly secondary radiation. The operator uses protective barriers, correct positioning of the patient and careful techniques to reduce radiation exposure. The effects of radiation are cumulative an d permanent. They may be stochastic or nonstochastic, and somatic and/ or genetic, and onset may be delayed for many years. To minimize expos ure of patient and operator, cardiologists need a better understanding of radiation physics and of cardiac x-ray equipment. Technical breakt hroughs such as digital imaging, pulse fluoroscopy, reduction of frame rates from 60 or 30 frames/s to 15 frames/s, and progression to the f ilmless laboratory will. substantially reduce radiation. This review d iscusses current cardiac x-ray equipment, possible future developments , radiation, and techniques for reducing radiation and improving safet y in the cardiac catheterization laboratory.