K. Perisinakis et al., Accurate assessment of patient effective radiation dose and associated detriment risk from radiofrequency catheter ablation procedures, CIRCULATION, 104(1), 2001, pp. 58-62
Citations number
22
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background-Radiofrequency (RF) cardiac catheter ablation procedures may req
uire extended fluoroscopic exposure resulting in elevated radiation risk. T
he aim of the present study was to accurately establish RF ablation radiati
on risk levels and to provide means for accurate patient risk estimation fr
om studies performed in any electrophysiology laboratory.
Methods and Results-Fluoroscopy required during cardiac ablation was classi
fied into 4 types identified by beam orientation and irradiated tissue: (l)
posteroanterior exposure during catheter advancing from the groin to the he
art, (2) posteroanterior heart exposure, (3) left anterior oblique heart ex
posure, and (4) right anterior oblique heart exposure. The duration of each
exposure was monitored in 24 patients undergoing RF cardiac ablation, Dose
per minute of fluoroscopy was measured at 15 organs/tissues for each proje
ction with the use of anthropomorphic phantom and thermoluminescence dosime
try, The effective dose rate was 219, 144, 136, and 112 mu Gy/min for groin
-to-heart posteroanterior, posteroanterior, left anterior oblique, and righ
t anterior oblique exposure, respectively. A typical ablation procedure res
ults in a total effective dose of 8.3 mSv per hour of fluoroscopy, The aver
age excess of fatal cancers was estimated to be 650 and 480 per million pat
ients undergoing RF ablation requiring 1 hour of fluoroscopy fur US and UK
populations, respectively. The average risk for genetic defects was determi
ned to be 1 per million births.
Conclusions-Radiation risk from RF cardiac ablation is moderate compared wi
th other complications, but it may highly exceed radiation risk from common
radiological procedures. Efforts should be made toward minimization of pat
ient radiation risk from RF ablation procedures.