Reduction of radiation exposure during ablation of atrial fibrillation
| Autor: | Ralph Schneider, Cindy Schneider, Aenne Glass, Jörg Lauschke, Dietmar Bänsch, Tina Tischer |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Ablation of atrial fibrillation Catheter ablation Patient Positioning law.invention Pulmonary vein Imaging Three-Dimensional law Internal medicine Atrial Fibrillation medicine Humans medicine.diagnostic_test business.industry Body Surface Potential Mapping Atrial fibrillation Phlebography Middle Aged Radiation Exposure Ablation medicine.disease Treatment Outcome Surgery Computer-Assisted Dose area product Pulmonary Veins Fluoroscopy Angiography Cardiology Catheter Ablation Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Herz. 40(6) |
| ISSN: | 1615-6692 |
| Popis: | Pulmonary vein isolation (PVI) during ablation of atrial fibrillation (Afib) may be associated with long fluoroscopy duration. Although most current publications report on fluoroscopy time (FT), the dose–area product (DAP) may be a more valuable parameter for depicting radiation exposure. The aim of our study was to describe a method to reduce DAP by simple means during ablation of Afib. Patients undergoing Afib ablation using a three-dimensional (3D) mapping system were assigned to two fluoroscopy protocols: (1) standard settings with 7.5 pictures/s and collimation to the heart, fluoroscopy as needed for the convenience of the operator (standard group, SG); and (2) strict collimation to the left atrium, a frame rate of 4 pictures/s, shortened pulmonary vein angiography sequences, and maximal orientation by the 3D mapping system (redDAP group). The primary endpoint was DAP. The study comprised 206 patients, who were assigned to the SG (n = 101, 49 %) or to the redDAP group (n = 105, 51 %). Mean FT was significantly reduced from 29.9 ± 11.3 min (SG) to 13.3 ± 8.3 min (redDAP group); mean DAP was reduced by approximately 90 % from 8,690 ± 5,727 to 837 ± 647 cGycm2. The groups did not differ significantly in body mass index (28.8 ± 4.1 vs. 29.0 ± 5.0). PVI could be achieved in 98 of 101 patients (97 %) from the SG group and in all patients (100 %) from the redDAP group. Procedure time was significantly longer in the redDAP group (160.9 ± 35.7 vs. 138.1 ± 34.3 min). Radiation exposure during Afib ablation procedures can be reduced with simple means by strict collimation to the left atrium, a frame rate of 4 pictures/s, shortened pulmonary vein angiography sequences, and maximal 3D orientation. |
| Databáze: | OpenAIRE |
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