Conceptus radiation dose and risk from cardiac catheter ablation procedures

Background-The aim of the current study was to estimate the conceptus radia tion dose and risk associated with fluoroscopic imaging during a catheter a blation procedure for supraventricular tachycardia performed on the expecta nt mother. Methods and Results-Exposure parameters and fluoroscopy times for each proj ection of the cardiac ablation procedure performed in 20 female patients of childbearing age were recorded. Radiation doses for a potential conceptus were estimated by using dose data obtained in anthropomorphic phantoms simu lating pregnancy at the first, second, and third trimesters. Dose measureme nts were carried out using thermoluminescent dosimeters. For a typical exam ination, the average radiation dose to the conceptus was < 1 mGy in all per iods of gestation. Average excess fatal cancer was 14.5/10(6) unborn childr en irradiated during the first postconception weeks. Corresponding values f or the second and third trimesters were 30 and 55.7/10(6), respectively. Th e risk for hereditary effects in future generations was 1.5/10(6) cases for conceptus irradiation during the first postconception weeks. Corresponding values for the second and third trimesters were 3.0 and 5.6/10(6), respect ively. Formulas and dose data are presented for estimating the conceptus ri sk from any technique and x-ray system used for catheter ablation procedure s. Conclusions-A typical catheter ablation procedure results in a very small i ncrease in risk of harmful effects to the conceptus. However, estimation of conceptus dose from catheter ablation procedures is always needed to asses s the risk to the individual developing in utero.