Patient and staff radiation dosimetry during cardiac electrophysiology studies and catheter ablation procedures: a comprehensive analysis

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Abstract
Aims To perform a comprehensive analysis of all aspects of patient and in-room personnel radiation dosimetry in interventional electrophysiology. Methods and results Measurements were performed during 19 diagnostic electrophysiology studies and 24 catheter ablations. Kerma-area product and exposure time values were 48.7 (6.4–230) Gy cm2 and 25.5 (4.4–79.2) min for ablation, and 12.5 (4.5–117.2) Gy cm2 and 4.5 (1.2–31) min for diagnostic studies, respectively. Patient effective doses were 15.2 (2.1–59.6) mSv for ablation and 3.2 (1.3–23.9) mSv for diagnostic procedures. Radiation risk to the patient was estimated to be up to eight cases of fatal cancer in 10 000 procedures. The risk of development of fatal cancer was less than 3×10−6 per procedure to the primary operator. The risk for the nurse and technician was much lower. The dose per procedure for the primary operator was 7.1 µGy at the eyes, 0.79 µGy at the chest under the lead apron, 13.68 µGy at the chest over the apron, 3.82 µGy at the thyroid, 17.76 µGy at the left hand, and 12.11 µGy at the left knee. Conclusion As far as radiation exposure is concerned, electrophysiology studies followed by radiofrequency ablation are safe procedures for both patient and personnel when performed in catheterization laboratories with modern equipment, experienced operators, and standard safety precautions.