title: Impact of collimation on radiation exposure during interventional electrophysiology.
abstract: OBJECTIVE
  Fluoroscopy remains a cornerstone imaging technique in contemporary electrophysiology practice. We evaluated the impact of collimation to the 'minimal required field size' on clinically significant parameters of radiation exposure.
  
  
  RESULTS
  Radiation dose measured by dose area product (DAP) and radiation dose rate measured by DAP per minute of fluoroscopy were determined for all 571 electrophysiology procedures performed in a single electrophysiology laboratory from January 2010 to December 2010. Data from 205 procedures performed by one interventional electrophysiologist, who instituted a practice of routinely collimating to the minimum required visual fluoroscopy field on a case-by-case basis, were compared with data from 366 procedures performed by the three other experienced interventional electrophysiologists using the laboratory who continued their existing practice of ad hoc collimation. Significant reductions in radiation exposure were seen with the practice of routine maximal collimation. The largest reductions were seen during 'simple' ablation procedures.
  
  
  CONCLUSIONS
  A practice of routinely collimating to the minimum required visual fluoroscopy field results in significant reductions in radiation exposure when compared with a usual approach to collimation. This may have important implications for risk of malignancy in patients and operators.
authors.affiliation: Department of Cardiology,  Royal Melbourne Hospital, Melbourne,  Australia.
authors.forename: Tomos E
authors.initials: TE
authors.lastname: Walters
authors.forename: Peter M
authors.initials: PM
authors.lastname: Kistler
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Morton
authors.forename: Paul B
authors.initials: PB
authors.lastname: Sparks
authors.forename: Karen
authors.initials: K
authors.lastname: Halloran
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Kalman
mesh_terms: D022062:Electrophysiologic Techniques, Cardiac / Q000009:adverse effects*; D005471:Fluoroscopy; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control*; D016272:Occupational Health; D061214:Patient Safety; D011829:Radiation Dosage; D011834:Radiation Monitoring; D011835:Radiation Protection / Q000379:methods*; D015641:Radiography, Interventional / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors