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
This article has been cited by other articles:
 |
|
 |
|
  R. Liew, V. Baker, L. Richmond, K. Rajappan, D. Gupta, M. Finlay, G. Thomas, M. Earley, S. Sporton, S. Harris, et al. A randomized-controlled trial comparing conventional with minimal catheter approaches for the mapping and ablation of regular supraventricular tachycardias Europace, May 2, 2009; (2009) eup108v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. Eckart and L. M. Epstein Interventional Therapy for Atrial and Ventricular Arrhythmias Card. Surg. Adult, January 1, 2008; 3(2008): 1357 - 1374. [Full Text]
|
|
|
|
 |
|
 P. Kirchhof, A. Auricchio, J. Bax, H. Crijns, J. Camm, H.-C. Diener, A. Goette, G. Hindricks, S. Hohnloser, L. Kappenberger, et al. Outcome parameters for trials in atrial fibrillation: executive summary: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA) Eur. Heart J., November 2, 2007; 28(22): 2803 - 2817. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Kirchhof, A. Auricchio, J. Bax, H. Crijns, J. Camm, H.-C. Diener, A. Goette, G. Hindricks, S. Hohnloser, L. Kappenberger, et al. Outcome parameters for trials in atrial fibrillation: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork and the European Heart Rhythm Association Europace, November 1, 2007; 9(11): 1006 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Calkins, J. Brugada, D. L. Packer, R. Cappato, S.-A. Chen, H. J.G. Crijns, R. J. Damiano Jr, D. W. Davies, D. E. Haines, M. Haissaguerre, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and Approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm Society. Europace, June 1, 2007; 9(6): 335 - 379. [Full Text] [PDF]
|
|
|
|
|
|
E. P. Efstathopoulos, D. G. Katritsis, S. Kottou, N. Kalivas, E. Tzanalaridou, E. Giazitzoglou, S. Korovesis, and K. Faulkner Patient and staff radiation dosimetry during cardiac electrophysiology studies and catheter ablation procedures: a comprehensive analysis Europace, June 1, 2006; 8(6): 443 - 448. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Earley, R. Showkathali, M. Alzetani, P. M. Kistler, D. Gupta, D. J. Abrams, J. A. Horrocks, S. J. Harris, S. C. Sporton, and R. J. Schilling Radiofrequency ablation of arrhythmias guided by non-fluoroscopic catheter location: a prospective randomized trial Eur. Heart J., May 2, 2006; 27(10): 1223 - 1229. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Chida, H. Saito, H. Otani, M. Kohzuki, S. Takahashi, S. Yamada, K. Shirato, and M. Zuguchi Relationship between fluoroscopic time, dose-area product, body weight, and maximum radiation skin dose in cardiac interventional procedures. Am. J. Roentgenol., March 1, 2006; 186(3): 774 - 778. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Padovani and E. Quai Patient dosimetry approaches in interventional cardiology and literature dose data review Radiat Prot Dosimetry, December 1, 2005; 117(1-3): 217 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Lickfett, M. Mahesh, C. Vasamreddy, D. Bradley, V. Jayam, Z. Eldadah, T. Dickfeld, D. Kearney, D. Dalal, B. Luderitz, et al. Radiation Exposure During Catheter Ablation of Atrial Fibrillation Circulation, November 9, 2004; 110(19): 3003 - 3010. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Satti and L. M. Epstein Cardiologic Interventional Therapy for Atrial and Ventricular Arrhythmias Card. Surg. Adult, January 1, 2003; 2(2003): 1253 - 1270. [Full Text]
|
|
|
|
|
|
J. Damilakis, N. Theocharopoulos, K. Perisinakis, E. Manios, P. Dimitriou, P. Vardas, and N. Gourtsoyiannis Conceptus Radiation Dose and Risk From Cardiac Catheter Ablation Procedures Circulation, August 21, 2001; 104(8): 893 - 897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Perisinakis, J. Damilakis, N. Theocharopoulos, E. Manios, P. Vardas, and N. Gourtsoyiannis Accurate Assessment of Patient Effective Radiation Dose and Associated Detriment Risk From Radiofrequency Catheter Ablation Procedures Circulation, July 3, 2001; 104(1): 58 - 62. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kottkamp, B. Hugl, B. Krauss, U. Wetzel, A. Fleck, G. Schuler, and G. Hindricks Electromagnetic Versus Fluoroscopic Mapping of the Inferior Isthmus for Ablation of Typical Atrial Flutter : A Prospective Randomized Study Circulation, October 24, 2000; 102(17): 2082 - 2086. [Abstract] [Full Text] [PDF]
|
|