From the Departments of Cardiology and Medical Physics, Westmead
Hospital, Westmead, Sydney, Australia.
Correspondence to Prof D.L. Ross, Department of Cardiology, Westmead Hospital, Westmead, NSW, 2145, Australia.
Background—Radiofrequency
ablation may be associated with prolonged fluoroscopy times. Previous
studies have calculated radiation risks by measuring the radiation dose
at a limited number (6) of body sites. This is an inherently inaccurate
measure. Our study aimed to quantify more precisely patient-related
radiation risks associated with radiofrequency ablation for
supraventricular tachycardia.
Methods and Results—Nine female patients having radiofrequency
ablation for supraventricular tachycardia were
studied. The radiation dose was determined at 41 body sites in each
patient with the use of thermoluminescent dosimeters and was correlated
with that measured simultaneously with a Diamentor
dose-area product meter. The estimated mean organ doses (mGy) per
60 minutes of fluoroscopy were: lungs 30.8; bone marrow 4.3; left
breast 5.1; right breast 3.5; and thyroid 2.4. From the average organ
doses, the estimated mean total lifetime excess risk of a fatal
malignancy was 294 per million cases (0.03%) per 60 minutes of
fluoroscopy. The risk calculation from the Diamentor dose-area
product and thermoluminescent dosimeters were similar, suggesting
that radiation dose was measured accurately. The estimated risk of
radiation-induced malignancy increased with increasing body mass index
(P=0.03).
Conclusions—Prolonged fluoroscopy during radiofrequency ablation
may potentially cause a small increase in the lifetime risk of fatal
malignancy, with lung malignancy being most likely. This risk is small
only with the use of techniques and x-ray equipment optimized to keep
radiation as low as possible. The risk is increased in obese patients.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Risk to Patients From Radiation Associated With Radiofrequency Ablation for Supraventricular Tachycardia
Key Words: radiation risks • RF ablation • fluoroscopy
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