Abstract 3313: Significant Reduction Of Radiation Exposure During Ablation Can Be Achieved By Simple Dose Limitation Manoeuvres
Introduction Fluoroscopy guided percutaneous catheter ablation is now the first line treatment for many arrhythmias. High levels of radiation are a potential risk to both patient and operators during long complex procedures. We compared the effects of practical dose reduction manoeuvres with standard settings during a one-year period.
Methods Radiation dose and screening time were analysed over 12 months for ablation procedures performed before and after dose reduction manoeuvres. Ablations were classified as simple (AV nodal re-entrant tachycardias, right atrial flutters and accessory pathway procedures) or complex (congenital heart disease arrhythmias, left atrial fibrillation and tachycardia). The following changes were then made after an initial 5 month period:
reduced pulsed fluoroscopy rate
removal of secondary radiation grids
optimising use of collimation
maximizing field of view
halving frame rate for acquisitions to 6.25 frames per second.
Results A total of 311 ablation procedures (224 simple, 87 complex) were analysed. Screening times were unchanged before and after dose reduction manoeuvres (Simple 24.7±2.3 vs 21.5±1.8 min p=ns; Complex 53.8±4.6 vs 53.1±2.7 min p=ns). There were 63% and 36% reductions in radiation exposure after dose reduction interventions for simple (18.8 vs 6.8 Gycm2) and complex ablation procedures (55.4 vs 33.9 Gycm2) respectively (Figure⇓).
ConclusionSafety of ablation procedures can be improved by simple radiation protection manoeuvres. These measures can significantly reduce radiation doses by >90% compared to published data (simple ablations 75–250 Gycm2).