Reduction of radiation exposure time during catheter ablation with the use of pulsed fluoroscopy.
Prolonged exposure to radiation during radiofrequency catheter ablation implies a potential risk of radiodermatitis, neoplasm and genetic defects to the patient and to the operator-physician. The use of pulsed fluoroscopy is thought to reduce such a risk because the radiation dose decreases for the same period of time. The aim of the present study was to compare the radiation exposure time during pulse and continuous radiofrequency catheter ablation.


METHODS
Procedures were divided according to the sort of fluoroscopy utilized and the last four cases of atrioventricular (AV) junction ablation, four of atrial flutter, five of atrial tachycardia, 16 of AV node reentrant tachycardia, 16 of AV tachycardia and 10 of ventricular tachycardia in which pulsed and continuous fluoroscopy were utilized were respectively separated into Group I (pulse fluoroscopy) and Group II (continuous fluoroscopy) with 55 patients in each group. Fluoroscopy was generated by the same device in the two groups. Continuous fluoroscopy used 2 mA and automatic kV adjustment (automatic brightness stabilizer) ranging from 70 to 110 kV. Pulsed fluoroscopy was set at 7 squares/s with 25 mA and automatic kV adjustment. Fluoroscopy time was registered by the fluoroscopy device counter.


RESULTS
Procedure duration, success rate and complications did not differ between Groups I and II. Fluoroscopy time, however, was 4.4+/-4 min during pulsed fluoroscopy and 27+/-23 min during continuous fluoroscopy (p=0.001).


CONCLUSIONS
During radiofrequency catheter ablation procedures, the use of pulsed fluoroscopy set at 7 squares/s, decreases the radiation exposure time by 80% as compared to continuous fluoroscopy without changing procedure duration and success rate.
Scanavacca
M
M
Heart Institute, University of São Paulo Medical School, Brazil.
d'Avila
A
A
Velarde
J L
JL
Reolão
J B
JB
Sosa
E
E
D006328:Cardiac Catheterization; D017115:Catheter Ablation / Q000379:methods*; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D009784:Occupational Diseases / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control*; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods; D012449:Safety; D013610:Tachycardia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome