Decreased operator X-ray exposure by optimized fluoroscopy during radiofrequency ablation of common atrial flutter.

PURPOSE: To evaluate operator and patient irradiation during radiofrequency ablation (RFA) of common atrial flutter (AF) using three different fluoroscopy settings.

MATERIAL AND METHOD: A total of 38 patients who underwent RFA of AF with three different fluoroscopy settings (low dose, standard dose and collimated field) were included. Twelve patients (11 men, 1 woman; mean age, 67±12 [SD]years) were included in the low dose group (3.75 frames per second), 13 patients (13 men; mean age, 66±8 [SD]years) were included in the standard dose group (7.5 frames per second) and 13 patients (13 men; mean age, 71±12 [SD]years) were included in the collimated field group (7.5 frames per second). Operator and patient exposure were compared between groups.

RESULT: No differences in procedure time and radiation exposure were found between the three groups. In the low dose group, mean operator X-ray exposures of eye-lens (4.7±2.9 [SD]μSv/h; range: 0.9-10.5μSv/h), whole body (1.6±1.2 [SD]μSv/h; range 0.5-3.6μSv/h) and hand skin (11.1±10.8 [SD] μSv/h; range 2.4-35.4μSv/h) were significantly lower than those in the standard dose group (P<0.001). Significant patient dose reduction was found between low dose group (0.7±0.4 [SD]Gy/h; range: 0.3-0.9Gy/h) and standard (1.7±0.5 [SD]Gy/h; range: 0.8 to 3.9Gy/h) and collimated (1.8±0.5 [SD]Gy/h; range: 0.7-3.0Gy/h) groups (P<0.01).

CONCLUSION: The use of a low dose setting (3.75 f/s) during fluoroscopy dramatically reduces operator's irradiation during RFA of AF by a mean of 90%.