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Radiation Exposure of Patient and Physician during Implantation and Upgrade of Cardiac Resynchronization Devices
Author(s) -
BUTTER CHRISTIAN,
SCHAU THOMAS,
MEYHOEFER JUERGEN,
NEUMANN KLAUS,
MINDEN HANS H.,
ENGELHARDT JOERG
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.02765.x
Subject(s) - medicine , cardiac resynchronization therapy , dosimeter , fluoroscopy , nuclear medicine , forehead , radiation exposure , radiation protection , thorax (insect anatomy) , radiology , dosimetry , cardiology , surgery , heart failure , ejection fraction , anatomy
Background: Cardiac resynchronization therapy (CRT) is often associated with extended fluoroscopic exposure during placement of the devices. The objective of this study was to measure the radiation exposure sustained by different parts of the body of patients and operators during fluoroscopically guided cardiac resynchronization device implantation.Methods: Dosimetry data were prospectively recorded in a series of 104 consecutive patients, who underwent resynchronization device implantation or upgrade in our cardiac catheterization laboratory. Five Chipstrate dosimeters were fixed to the patient's skin around the thorax (right and left paravertebral, right and left parasternal, and sternal positions), one dosimeter was attached to the forehead, and one to the pubis. The operator was equipped with one dosimeter on the forehead at eye level and a ring dosimeter was worn on the right hand.Results: Based on the maximum radiation dose of 9.2 mSv measured at the operator's hand in a single implantation session, it might be recommended to conservatively limit the number of implantations to four per month (an annual limit value of 500 mSv). At a mean dose of 1.2 mSv, this number can be increased sevenfold.Conclusion: In patients, incipient deterministic radiation effects can theoretically be observed at dose area product >400 Gy•cm 2 , a dose applied in 2.9% of CRT implantation procedures. Special follow‐up programs are considered necessary for these patients and for operators, as the latter may be exposed over many years given the unknown long‐term impact of chronic radiation exposure and the nature of current complex electrophysiology and device procedures. (PACE 2010; 1003–1012)