Asymmetric collimation can significantly reduce patient radiation dose during pulmonary vein isolation†

Abstract

Implementation and effective application of an optimal asymmetric collimation approach would yield an average three- to nine-fold reduction of fluoroscopy dose during AF ablation procedures. This reduction exceeds what has been previously reported by implementing an electromagnetic catheter tracking approach. Furthermore, it can be easily integrated in the clinical workflow with limited additional one-time cost. Manufacturers of imaging systems should consider its implementation a priority, and physicians should adopt it in their workflow.

Reduction of Fluoroscopy Time and Radiation Dosage During Catheter Ablation for Atrial Fibrillation

“…Asymmetric collimation can achieve another 60-80 % reduction compared with normal collimation, although it has not yet been commercialised. 45 In contrast, magnification seems to show the same area as collimation, but increases the radiation dose by ADRC and increases DAP.…”

Results from a real-time dosimetry study during left atrial ablations performed with ultra-low dose radiation settings

“…Increased awareness lead to the development of ultra-low dose programs with optimized image processing and system settings, resulting in average doses that equal as little as 1% of an ablation procedure performed 6 years ago [ 2 , 6 ].…”

Significant radiation reduction in interventional fluoroscopy using a novel eye controlled movable region of interest

“…This can be achieved by either the use of shaped filters or temporal modulation of average beam intensity. 4,[7][8][9][10][11][12][13][14][15] Once this is done, a match of the overall brightness and contrast between the CROI and the remainder of the IA is performed to provide an image with a relatively standard appearance.…”

“…Gross motions of the entire imaging system can be reduced by moving the unattenuated region within the IA. This can be accomplished by a variety of means including manual steering, 4,11 scene processing to detect an object of interest (e.g., the tip of a moving catheter), [7][8][9]16 or by using the operator's gaze as the control signal. 17 This paper reports the first results obtained with a system using an innovative gaze-controlled system (developed by ControlRad Systems).…”