Abstract 16746: Lower Fluoroscopy Frame Rate During Device Implantation Reduces Radiation Exposure
Introduction: Radiation exposure is related in a dose-dependent fashion to long-term risk of a variety of malignancies for both patients and operators in the electrophysiology laboratory. All attempts to reduce the dose without compromising care should be taken.
Hypothesis: We examined whether decreasing fluoroscopy frame rate from 3 frames per second (FPS) to 2 FPS during permanent pacemaker (PPM) and implantable cardiac defibrillator (ICD) implantation can safely reduce radiation exposure without a detrimental impact in clinical outcomes.
Methods: Single or dual chamber device implantations performed at a single tertiary center from July 2011 to June 2013 were identified and enrolled into the study. Average fluoroscopy dose, fluoroscopy duration, case length, major complication rate, and procedure-related mortality were compared retrospectively. Complications were defined as any event requiring re-accessing the pocket, removal of hardware, additional procedures or medication changes.
Results: Out of a total of 183 patients 168 cases (52% PPM, 48% ICDs) with all required information were identified. Of those, 105 procedures were performed at 3FPS, while 63 implantations were performed at 2FPS. Single/dual and PPM/ICD implantations were similarly distributed among the 3 and 2 frames per second group (p=NS). Cases performed at 2FPS had a lower average dose area product (DAP) by 202 cgycm2 (699 vs. 497, p=0.034), representing a relative reduction of 28.9%. The reduction in frame rate was not associated with an increase in fluoroscopy time (10.1min at 2FPS vs. 11.1 min at 3FPS; p=0.36). There was no meaningful difference in case duration (94 min at 2FPS vs. 96min at 3FPS; p=0.70), and there was no significant difference in complication rate (6.3% at 2FPS vs. 8.7% at 3FPS; p=NS). Procedure-related mortality was zero in both groups.
Conclusions: Reducing the fluoroscopy frame rate from 3FPS to 2FPS leads to a significant reduction in radiation exposure and can be done safely, without an increase in case duration or complication rate.
- © 2013 by American Heart Association, Inc.