Abstract 19937: Novel Advances in Radiographic Imaging Yield Important Reductions in Radiation Exposure
Introduction: Radiographic imaging is required for ablation of complex arrhythmias and device implantation. Technological advances have been advocated to reduce radiation exposure, as measured by the Dose Area Product (DAP) and Air Kerma (AK).
Hypothesis: Advances in radiographic imaging reduce patient radiation exposure substantially.
Methods: 265 sequential patients underwent ablation procedures and device implants over a 6.5 month period on one of 4 systems. For each procedure, total fluoroscopy DAP and AK were divided by total fluoroscopy time from the Radiation Dose Structured Reports. Philips Allura Clarity FD20 (CLA) installed in 2014, employs novel image processing technology to reduce radiation exposure. The comparative arms were older Phillips and Siemens imaging systems 9-12 years of age, labeled systems B, C and D. Imaging was performed at low dose settings. Generalized linear models were used to quantify DAP rate and AK rate reduction effect per system, while controlling for patient BMI. Results: As shown in the Figure, DAP rate for CLA was estimated to be 56% lower than system B (p<0.001), 30% lower than system C (p<0.05) and 40% lower than system D (p<0.001) with 95% CI [45, 65], [13, 45] and [22, 54], respectively. The corresponding AK rate for CLA was estimated to be 55% lower than system B (p<0.001), 8% lower than system C (p=0.4) and 58% lower than system D (p<0.001) with 95% CI [45, 63], [-12, 25] and [47, 67], respectively. For every point of increased BMI, the DAP rate and AK rate increased by 6.4% and 6.5% respectively, independent of system used (p<0.001).
Conclusions: Advanced radiographic imaging technology, as represented by the CLA system, was associated with radiation exposure measured by DAP rates 30-56% lower and AK rates 8-58% lower than older systems. The impact of advancing technology should be taken into consideration when evaluating radiation risks for patients and staff.
Author Disclosures: B.D. Lindsay: None. J.O. Lopez: None. K. Wunderle: None. M.K. Chung: None. M.H. vanAlven: Employment; Significant; Philips.
- © 2016 by American Heart Association, Inc.