Safe procedures despite ultra low radiation doses during catheter ablations of atrial and ventricular arrhythmias—A multicenter experience
| Autor: | Nora Kaehler, Felix Bourier, Osman Tutdibi, Dimitra Katsani-Potempa, Martin Huemer, Rolf Michael Klein, Isabel Deisenhofer, Philipp Attanasio, Tobias Schreiber, Ulf Landmesser, Theresa Keller, Reinhard Niehues |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Radiofrequency ablation medicine.medical_treatment 030204 cardiovascular system & hematology Radiography Interventional law.invention 03 medical and health sciences 0302 clinical medicine Radiation Protection Left atrial law framerate reduction Germany medicine Fluoroscopy Humans 030212 general & internal medicine Major complication antiscatter grid Aged Retrospective Studies medicine.diagnostic_test business.industry Arrhythmias Cardiac General Medicine Middle Aged Radiation Exposure Ablation ablation therapy Catheter Multicenter study Catheter Ablation Female Cardiology and Cardiovascular Medicine Complication Nuclear medicine business radiation dose 600 Technik Medizin angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit |
| Popis: | Introduction: 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 μGym2 ), right atrial ablations (70.98 ± 94.79 μGym2 ) and ablations for ventricular tachycardias or PVCs (78.62 ± 66.59 μGym2 ). 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%. |
| Databáze: | OpenAIRE |
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