Journal article
X-Ray Exposure in Cardiac Electrophysiology: A Retrospective Analysis in 8150 Patients Over 7 Years of Activity in a Modern, Large-Volume Laboratory
Journal of the American Heart Association, Vol.7(11), p.n/a
06/05/2018
DOI: 10.1161/JAHA.117.008233
PMCID: PMC6015357
PMID: 29789334
Abstract
Background-Only a few studies have systematically evaluated fluoroscopy data of electrophysiological and device implantation procedures. Aims of this study were to quantify ionizing radiation exposure for electrophysiological/device implantation procedures in a large series of patients and to analyze the x-ray exposure trend over years and radiation exposure in patients undergoing atrial fibrillation ablation considering different technical aspects.
Methods and Results-We performed a retrospective analysis of all electrophysiological/device implantation procedures performed during the past 7 years in a modern, large-volume laboratory. We reported complete fluoroscopy data on 8150 electrophysiological/device implantation procedures (6095 electrophysiological and 2055 device implantation procedures); for each type of procedure, effective dose and lifetime attributable risk of cancer incidence and mortality were calculated. Over the 7-year period, we observed a significant trend reduction in fluoroscopy time, dose area product, and effective dose for all electrophysiological procedures (P<0.001) and a not statistically significant trend reduction for device implantation procedures. Analyzing 2416 atrial fibrillation ablations, we observed a significant variability of fluoroscopy time, dose area product and effective dose among 7 different experienced operators (P<0.0001) and a significant reduction of fluoroscopy use over time (P<0.0001) for all of them. Considering atrial fibrillation ablation techniques, fluoroscopy time was not different (P = 0.74) for radiofrequency catheter ablation in comparison with cryoablation, though cryoablation was still associated with higher dose area product and effective dose values (P<0.001).
Conclusions-Electrophysiological procedures involve a nonnegligible x-ray use, leading to an increased risk of malignancy. Awareness of radiation-related risk, together with technological advances, can successfully optimize fluoroscopy use.
Details
- Title: Subtitle
- X-Ray Exposure in Cardiac Electrophysiology: A Retrospective Analysis in 8150 Patients Over 7 Years of Activity in a Modern, Large-Volume Laboratory
- Creators
- Michela Casella - Centro Cardiologico MonzinoAntonio Dello Russo - Centro Cardiologico MonzinoEleonora Russo - Centro Cardiologico MonzinoValentina Catto - Centro Cardiologico MonzinoFrancesca Pizzamiglio - Centro Cardiologico MonzinoMartina Zucchetti - Centro Cardiologico MonzinoBenedetta Majocchi - Centro Cardiologico MonzinoStefania Riva - Centro Cardiologico MonzinoGiulia Vettor - Centro Cardiologico MonzinoMaria Antonietta Dessanai - Centro Cardiologico MonzinoGaetano Fassini - Centro Cardiologico MonzinoMassimo Moltrasio - Centro Cardiologico MonzinoFabrizio Tundo - Centro Cardiologico MonzinoCarlo Vignati - Centro Cardiologico MonzinoSergio Conti - Centro Cardiologico MonzinoAlice Bonomi - Centro Cardiologico MonzinoCorrado Carbucicchio - Centro Cardiologico MonzinoLuigi Di Biase - Albert Einstein College of MedicineAndrea Natale - Texas Cardiac ArrhythmiaClaudio Tondo - Centro Cardiologico Monzino
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.7(11), p.n/a
- DOI
- 10.1161/JAHA.117.008233
- PMID
- 29789334
- PMCID
- PMC6015357
- NLM abbreviation
- J Am Heart Assoc
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Publisher
- Wiley
- Number of pages
- 18
- Grant note
- Biosense Webster Medtronic Boston Scientific Abbott; Abbott Laboratories
- Language
- English
- Date published
- 06/05/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984823122202771
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