Effect of Modern Dose-Reduction Technology on the Exposure of Interventional Cardiologists to Radiation in the Catheterization Laboratory

Faroux, Laurent; Blanpain, Thierry; Nazeyrollas, Pierre; Tassan-Mangina, Sophie; Heroguelle, Virginie; Tourneux, Christophe; Baudin, Florian; Metz, Damien

doi:10.1016/j.jcin.2017.10.022

Cited by 8 publications

(8 citation statements)

References 3 publications

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“…10,23,24 This difference could be explained by the fact that all our TAVI procedures was performed in a modern cathlab equipped with a dose-reduction system that has been shown to achieve a spectacular reduction in the estimated dose of radiation received by both patient and physician. 9,25,26 In our study, only the BSA was independently and strongly correlated with the overall ED. In contrast, while some variables were associated with the ED by univariate analysis, they were no longer associated by multivariate analysis.…”

Section: Discussionmentioning

confidence: 43%

Exposure to Ionizing Radiation in Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation

Villecourt¹,

Faroux²,

Blanpain

et al. 2020

The American Journal of Cardiology

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Section: Discussionmentioning

confidence: 43%

Exposure to Ionizing Radiation in Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation

Villecourt¹,

Faroux²,

Blanpain

et al. 2020

The American Journal of Cardiology

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“…With the same methodology, we showed that in the catheterisation laboratory, the average cardiologists' exposure to radiation ranged from 2 to 7 μSv for an average x-ray time of 8 min [20]. Here, physicians' exposure was higher with a median of 6 to 56 μSv, for a maximum of 614 μSv during a complex CRT procedure in an obese patient.…”

Section: Discussionmentioning

confidence: 78%

“…Here, physicians' exposure was higher with a median of 6 to 56 μSv, for a maximum of 614 μSv during a complex CRT procedure in an obese patient. In contrast, patients' exposure was comparable with mean DAP ranging from 1400 to 3000 cGy.cm 2 in the catheterisation laboratory [20] and median DAP ranging from 225 to 3200 cGy.cm 2 at the electrophysiology laboratory. This difference can be explained by the impossibility of using a lead screen during PM and ICD implantation (as cardiologists have to be close to the operative site, i.e.…”

Section: Discussionmentioning

confidence: 87%

Impact of cardiac resynchronisation therapy on cardiologists’ exposure to radiation during implantation of pacemakers and implantable cardioverter-defibrillators

et al. 2019

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Cardiologists are among the health professionals that are most exposed to ionizing radiation, but there is no recent study quantifying overexposure of physicians during cardiac resynchronisation therapy (CRT) procedures compared to ‘classical’ implantation of pacemakers (PMs) or implantable cardioverter-defibrillators (ICDs). We aimed to measure and compare operator exposure to radiation during implantation of PM and ICD with or without CRT. The study population comprised all PMs and ICDs implanted in a large referral centre over a six months period. The endpoint was operator radiation exposure, assessed using a personal electronic dosimeter located on operator’s chest. In total, 169 PM/ICD implantations were analysed, 19 of which included CRT. Compared with ‘classical’ implantation, cardiologist radiation exposure was 9-fold greater during CRT procedures (p < 0.001). Physician exposure was related to dose-area product (R2 = 0.21 during ‘classical’ implantations and R2 = 0.57 during CRT procedures). Our study shows that cardiologists’ exposure to radiation during CRT implantation was 9-fold greater than during procedures without CRT.

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“…Although this risk can be reduced by applying various forms of radiation protection and the "as low as reasonably achievable" (ALARA) principle, it remains still of great importance. Furthermore, the wearing of lead aprons is associated with a higher rate of work-related musculoskeletal pain (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Visualizable vs. standard, non-visualizable steerable sheath for pulmonary vein isolation procedures: Randomized, single-centre trial

Janosi

Debreceni

Janosa

et al. 2022

Front. Cardiovasc. Med.

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IntroductionSteerable sheaths (SSs) are frequently used to improve catheter contact during pulmonary vein isolation (PVI) procedures. A new type of visualizable (by electroanatomical mapping system) SS has become available in clinical treatment.PurposeWe aimed to compare procedural data of visualizable vs. non-visualizable steerable sheath assisted PVI procedures in patients with atrial fibrillation (AF).MethodsIn this single-centre randomized study, we enrolled a total of 100 consecutive patients who underwent PVI due to AF.ResultsA total of 100 patients were randomized into 2 groups (visualizable SS group: 50; non-visualizable SS group: 50). Acute ablation success was 100% and the rate of the first pass isolation were similar (92% vs. 89%; p = 0.88). Using visualizable SS, left atrial (LA) procedure time (53.1 [41.3; 73.1] min vs. 59.5 [47.6; 74.1] min.; p = 0.04), LA fluoroscopy time (0 [0; 0] s vs. 17.5 [5.5; 69.25] s; p < 0.01) and LA fluoroscopy dose (0 [0; 0.27] mGy vs. 0.74 [0.16; 2.34] mGy; p < 0.01) was significantly less, however, there was no difference in the total procedural time (90 ± 35.2 min vs. 99.5 ± 31.8 min; p = 0.13), total fluoroscopy time (184 ± 89 s vs. 193 ± 44 s; p = 0.79), and total fluoroscopy dose (9.12 ± 1.98 mGy vs. 9.97 ± 2.27 mGy; p = 0.76). Compared to standard, non-visualizable SS group, the number of radiofrequency ablations was fewer (69 [58; 80] vs. 79 [73; 86); p < 0.01) as well as total ablation time was reduced (1049 sec. [853; 1175] vs. 1265 sec. [1085; 1441]; p < 0.01) in the visualizable SS cohort. No major complications occurred in either group.ConclusionCompared to the standard, non-visualizable SS, visualizable SS significantly reduces the left atrial procedure time, RF delivery and fluoroscopy exposure without compromising its safety or effectiveness in patients undergoing PVI procedures for AF.

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Effect of Modern Dose-Reduction Technology on the Exposure of Interventional Cardiologists to Radiation in the Catheterization Laboratory

Cited by 8 publications

References 3 publications

Exposure to Ionizing Radiation in Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation

Exposure to Ionizing Radiation in Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation

Impact of cardiac resynchronisation therapy on cardiologists’ exposure to radiation during implantation of pacemakers and implantable cardioverter-defibrillators

Visualizable vs. standard, non-visualizable steerable sheath for pulmonary vein isolation procedures: Randomized, single-centre trial

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