Radiation exposure to patients' skin during cardiac resynchronization therapy.
OBJECTIVE
The purpose of the current study is to evaluate the patients' entrance skin dose (ESD) during cardiac resynchronization therapy (CRT).


RESULTS
Entrance skin doses were assessed during 16 CRT procedures. Seven of the 16 patients were upgrade of conventional pacemaker to CRT. The patients wore jackets which had 100 radiosensitive indicators placed on the back during the procedures. After the procedure, the patients' ESDs were calculated from the colour difference of the indicators. Eleven of the 16 patients were implanted devices with a defibrillator, and three patients those without a defibrillator. In the other two, the procedures failed. The average total fluoroscopic time (TFT), total numbers of cine frames, and the maximum ESDs were 56.7 +/- 28.0 min, 674 +/- 342 frames, and 1.0 +/- 0.6 Gy, respectively. Of the 16 patients, six received ESDs exceeding 1 Gy, TFT, total number of cine frames, and the maximum ESD tended to decrease as the operator experience increased.


CONCLUSIONS
The patients' ESDs during CRT procedures can exceed the thresholds for radiation skin injuries due to prolonged fluoroscopic times. Therefore, interventionalists should estimate the doses.
Department of Radiology, Teikyo University School of Medicine, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan. s-suzuki@med.teikyo-u.ac.jp
Shigeru
S
Suzuki
Shigeru
S
Furui
Takeshi
T
Yamakawa
Takaaki
T
Isshiki
Akiko
A
Watanabe
Ryu
R
Iino
Takashi
T
Kidouchi
Yoshiyasu
Y
Nakano
D000368:Aged; D001822:Body Burden; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D012867:Skin / Q000528:radiation effects*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000517:prevention & control*