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Safe procedures despite ultra low radiation doses during catheter ablations of atrial and ventricular arrhythmias—A multicenter experience
Author(s) -
Attanasio Philipp,
Huemer Martin,
Kaehler Nora,
Keller Theresa,
Schreiber Tobias,
Niehues Reinhard,
KatsaniPotempa Dimitra,
Klein Rolf Michael,
Landmesser Ulf,
Deisenhofer Isabel,
Tutdibi Osman,
Bourier Felix
Publication year - 2021
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/pace.14205
Subject(s) - medicine , fluoroscopy , catheter ablation , ablation , radiation exposure , catheter , dose area product , multicenter study , kerma , nuclear medicine , radiology , cardiology , dosimetry , randomized controlled trial
Despite the development of non‐fluoroscopic catheter visualization options, fluoroscopy is still used in most ablation procedures. The aim of this multicenter study was to evaluate the safety and efficacy of a new ultra‐low dose radiation protocol for EP procedures in a large number of patients. Methods and results A total of 3462 consecutive patients (male 1926 (55.6%), age 64.4 ± 14.0 years, BMI 26.65 ± 4.70) undergoing radiofrequency ablation (left atrial (n = 2316 [66.9%], right atrial (n = 675 [19.5%], or ventricular (n = 471 [13.6%]) in three German centers were included in the analysis. Procedures were performed using a new ultra‐low dose protocol operating at 8nGy for fluoroscopy and 36nGy for cine‐loops. Additionally a very low framerate (2‐3FPS) was used. Using the new protocol very low Air kerma‐area product (KAP) values were achieved for left atrial ablations (104.25 ± 84.22 μGym 2 ), right atrial ablations (70.98 ± 94.79 μGym 2 ) and ablations for ventricular tachycardias or PVCs (78.62 ± 66.59 μGym 2 ). Acute procedural success was achieved in 3289/3388 (97.1%) while the rate of major complications was very low compared to previously published studies not using low dose settings (n = 20, 0.6%). Conclusion The ultra‐low dose, low framerate protocol leads to very low radiation doses for all EP procedures while neither procedural time, fluoroscopy time nor success or complication rates were compromised. When compared to current real‐world Air KAP data the new ultra‐low dose fluoroscopy protocol reduces radiation exposure by more than 90%.