title: Use of fluoroscopy in clinical electrophysiology in Europe: results of the European Heart Rhythm Association Survey.
abstract: Despite the advent of non-fluoroscopic technologies, fluoroscopy remains the cornerstone of imaging in most interventional electrophysiological procedures, from diagnostic studies to ablation interventions and device implantation. The purpose of the European Heart Rhythm Association survey was to provide an insight into regulatory policies and physicians' clinical practice when using fluoroscopy during ablation procedures and device implantation. The survey has shown that only 50% of the participating centres worked with low frame rates (3-6 frames per second) and that the left anterior oblique projection, with higher radiation exposure for the physician, is used for nearly every ablation target. Although three-dimensional imaging systems may reduce the radiation exposure, most centres never used these systems for standard ablation procedures and a trend is that non-fluoroscopy technologies are even less frequently used than in 2012, when the use of robotic systems was still rare. Even less costly equipment such as lead gloves, lead glass cabins, or radiation absorbing pads are still not routinely used.
authors.affiliation: Department of Cardiology, MedizinischeKlinik I, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistrasse 15, München 81377, Germany heidi.estner@med.uni-muenchen.de.
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Estner
authors.affiliation: 2nd Cardiology Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Grazia Bongiorni
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen N-5021, Norway Department of Clinical Sciences, University of Bergen, Bergen N-5021, Norway.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Second Cardiology Department, Attikon University Hospital, University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Dagres
authors.affiliation: Cardiology Department, Ramon y Cajal Hospital, Alcalá University, CarreteraColmenar Viejo, Madrid 28034, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernandez-Madrid
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala 75185, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
mesh_terms: D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D022062:Electrophysiologic Techniques, Cardiac / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005471:Fluoroscopy / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D019919:Prosthesis Implantation / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000706:statistics & numerical data*; D015641:Radiography, Interventional / Q000706:statistics & numerical data*
keywords: 3D systems; Ablation; EHRA survey; EP wire; Electrophysiology; Exposure; Fluoroscopy; Implantable cardioverter-defibrillator; Radiation; X-ray