Radiation Exposure of Patient and Physician during Implantation and Upgrade of Cardiac Resynchronization Devices

Butter, Christian; Schau, Thomas; Meyhoefer, J.; Neumann, Klaus; Minden, H; Engelhardt, Joerg

doi:10.1111/j.1540-8159.2010.02765.x

Cited by 30 publications

(41 citation statements)

References 26 publications

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“…In the last 10 years, however, the issue of radiation exposure in interventional cardiology and electrophysiology has risen, and the “linear no‐threshold” model (which assumes that no safe dose exists and that the risk increases linearly with exposure) has been accepted by the majority of scientists . The radiation risk is particularly high for CRT implanting physicians, and a conservative recommendation to perform a maximum of 4 CRT implantations per month per implanter has been advocated …”

Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Electroanatomic Mapping System‐Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry

Greco

Maines

Marini

et al. 2016

Cardiovasc electrophysiol

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Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Electroanatomic Mapping System‐Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry

Greco

Maines

Marini

et al. 2016

Cardiovasc electrophysiol

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“…They also have shown that this exceed threshold dose for the induction of skin effects [10]. An other study addressing the operator's side of the problem demonstrated that the radiation exposure of the hands is approximately 9.2 mSv, and the other part of the body as 1.2 mSv [11].…”

Section: Discussionmentioning

confidence: 99%

Surgical Results of Left Ventricular Lead Implantation for Cardiac Resynchronization Therapy

Gür¹,

Gürkan²,

Gür³

et al. 2013

WJCS

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Objectives: Cardiac resynchronisation therapy (CRT) has proven its effectiveness in patients with symptomatic heart failure [1,2]. Although rewarding, the procedure of biventricular pacemaker implantation is challenging and subsequently fails in 8% -11% of patients. In patients whose left ventricular (LV) electrode cannot be placed transvenously, surgical implantation of an epicardial electrode can be achieved. Methods: Seventeen patients (14 male, 3 female), among whom LV electrode was failed to be placed transvenously, were included into our study. The epicardial LV electrodes were implanted through anterior mini thoracotomy. The patients were followed up for approximate six months and complications, ejection fraction (EF), New York Heart Association (NYHA) class, QRS durations as well as pacing parameters were recorded. Results: Mean age of the patients was 64.4 ± 7.01 (54 -79) years. Preoperative mean EF of the patients was 26.1% ± 3.7%. The LV electrode was placed at the optimal place on the lateral LV wall through left sided mini thoracotomy. The mean duration of the operation was 26.76  8.12 minutes and the mean hospital stay was 2.05  0.42 days. There were no intraoperative or postoperative complications. Only 1 patient had LV electrode displaced on the 3rd postoperative month and the patient was reoperated successfully. The EF on the 6th postoperative month was 29.4% ± 3.81% and NYHA class was 2.58 ± 0.5. The etiology of heart failure had no influence on outcome. Conclusions: Surgical implantation of LV lead is associated with low complication rates and excellent follow-up results without exposure to radiation. Thus epicardial leads can be proposed as equal alternative to transvenous leads.

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“…wynika, że procedury upgrade do CRT cechują się istotnie wyższymi wartościami analizowanych parametrów w porównaniu z modernizacjami niezwiązanymi z resynchronizacją [26]. W przypadku analizowanych relacji grup zabiegów CRT: de novo vs upgrade, zarówno średnie TFTs, jak i DAP były zbliżone.…”

Section: Omówienieunclassified

“…W przypadku analizowanych relacji grup zabiegów CRT: de novo vs upgrade, zarówno średnie TFTs, jak i DAP były zbliżone. Podobnie jak u innych autorów nie stwierdzono statystycznie istotnej różnicy między badanymi wielkościami TFTs i DAP [26,27]. W sytuacji zabiegów CRT zwraca uwagę znaczący udział w dawce skumulowanej trybu HLF (do 67%), 3-krotnie większy w porównaniu z wartościami średnimi dla procedur konwencjonalnych.…”

Section: Omówienieunclassified

Radiographic implications of procedures involving cardiac implantable electronic devices (CIEDs) – Selected aspects

Steckiewicz

Kosior

Świętoń

et al. 2017

Med Pr

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StreszczenieWstęp: Realizacja części procedur CIED (cardiac implantable electronic device -stałej elektroterapii serca) wymaga zastosowania promieniowania rentgenowskiego (rtg.), co znajduje odzwierciedlenie w czasie ekspozycji TFTs (total fluoroscopy times -łącz-ny czas naświetlania) oraz wielkości dawki promieniowania rtg. wyemitowanej na skórę pacjenta (dose area product -DAP). Materiał i metody: Badaniem retrospektywnym dotyczącym lat 2012-2015 objęto 522 procedury CIED (u 176 kobiet i 346 męż-czyzn, średnia wieku: 75±11 lat), z których 424 były zabiegami pierwszorazowymi (de novo), a 98 powtórnymi (upgrade), wymagającymi wprowadzenia nowej elektrody i zmiany urządzenia. Zarejestrowane po ich realizacji parametry TFTs i DAP odniesiono do wymienionych poniżej grup. Grupę 424 zabiegów de novo tworzyły: 203 implantacje stymulatorów (pacemaker -PM), 171 implantacji kardiowerterów-defibrylatorów (implantable cardiowerter-defibrylator -ICD), w których obrębie niezależnie wyodrębniono układy 1-i 2-jamowe, oraz 50 implantacji układów resynchronizujących (cardiac resynchronization therapy -CRT). W przypadku grupy 98 procedur upgrade porównano parametry między 2 podgrupami zabiegów -tylko do CRT oraz tylko w obrębie PM i ICD. Wyniki: Najniższe wartości TFTs i DAP towarzyszyły implantacjom PM, pośrednie -ICD, z wyraźnym wzrostem w przypadku układów 2-jamowych w stosunku do 1-jamowych. Najwyższe wartości TFTs i DAP cechowały zabiegi CRT. Zabiegom upgrade do CRT towarzyszyły 4-krotnie większe wartości TFTs i DAP w porównaniu z upgrade niezwiązanym z CRT. W przypadku zabiegów CRT de novo i CRT upgrade średnie wartości mierzonych parametrów były zbliżone. Wnioski: Czas ekspozycji i wielkość DAP pozostawały dodatnio związane z zaawansowaniem procedury CIED, przy czym zabiegi z zakresu CRT wyróżniały się ich największymi wartościami. Med. Pr. 2017;68(3):363-374 Słowa kluczowe: promieniowanie rtg., wejściowa dawka powierzchniowa, pracownicy medyczni, fluoroskopia, rozruszniki serca, defibrylatory implantowane Abstract Background: Some cardiac implantable electronic device (CIED) implantation procedures require the use of X-rays, which is reflected by such parameters as total fluoroscopy time (TFT) and dose-area product (DAP -defined as the absorbed dose multiplied by the area irradiated). Material and Methods: This retrospective study evaluated 522 CIED implantation (424 de novo and 98 device upgrade and new lead placement) procedures in 176 women and 346 men (mean age 75±11 years) over the period 2012-2015. The recorded procedure-related parameters TFT and DAP were evaluated in the subgroups specified below. The group of 424 de novo procedures included 203 pacemaker (PM) and 171 implantable cardioverter-defibrillator (ICD) implantation procedures, separately stratified by single-chamber and dual-chamber systems. Another subgroup of de novo procedures involved 50 cardiac resynchronization therapy (CRT) devices. The evaluated parameters in the group of 98 upgrade procedures were compared between 2 subgroups: CRT only and combi...

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Radiation Exposure of Patient and Physician during Implantation and Upgrade of Cardiac Resynchronization Devices

Cited by 30 publications

References 26 publications

Three‐Dimensional Electroanatomic Mapping System‐Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry

Three‐Dimensional Electroanatomic Mapping System‐Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry

Surgical Results of Left Ventricular Lead Implantation for Cardiac Resynchronization Therapy

Radiographic implications of procedures involving cardiac implantable electronic devices (CIEDs) – Selected aspects

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