title: Optimized Fluoroscopy Setting and Appropriate Project Position Can Reduce X-ray Radiation Doses Rates during Electrophysiology Procedures.
abstract: BACKGROUND
  Nonfluoroscopic three-dimensional electroanatomical system is widely used nowadays, but X-ray remains indispensable for complex electrophysiology procedures. This study aimed to evaluate the value of optimized parameter setting and different projection position to reduce X-ray radiation dose rates.
  
  
  METHODS
  From June 2013 to October 2013, 105 consecutive patients who underwent complex ablation were enrolled in the study. After the ablation, the radiation dose rates were measured by two different settings (default setting and optimized setting) with three projection positions (posteroanterior [PA] projection; left anterior oblique [LAO] 30° projection; and LAO 45° projection). The parameter of preset voltage, pulse width, critical voltage, peak voltage, noise reduction, edge enhancement, pulse rate, and dose per frame was modified in the optimized setting.
  
  
  RESULTS
  The optimized setting reduced radiation dose rates by 87.5% (1.7 Gy/min vs. 13.6 Gy/min, P < 0.001) in PA, 87.3% (2.5 Gy/min vs. 19.7 Gy/min, P < 0.001) in LAO 30°, 85.9% (3.1 Gy/min vs. 22.1 Gy/min, P < 0.001) in LAO 45°. Increase the angle of projection position will increase the radiation dose rate.
  
  
  CONCLUSIONS
  We can reduce X-ray radiation dose rates by adjusting the parameter setting of X-ray system. Avoiding oblique projection of large angle is another way to reduce X-ray radiation dose rates.
authors.forename: Bing-Bo
authors.initials: BB
authors.lastname: Hou
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yao
authors.forename: Ling-Min
authors.initials: LM
authors.lastname: Wu
authors.forename: Yu
authors.initials: Y
authors.lastname: Qiao
authors.forename: Li-Hui
authors.initials: LH
authors.lastname: Zheng
authors.forename: Li-Gang
authors.initials: LG
authors.lastname: Ding
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000601:surgery; D001281:Atrial Fibrillation / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D004594:Electrophysiology; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage