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Erschienen in:
03.05.2016 | Original Paper
Development of radiation exposure in patients undergoing pulmonary vein isolation in Germany between 2007 and 2014: great potential to minimize radiation dosage
Erschienen in: Clinical Research in Cardiology | Ausgabe 10/2016
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Aim
The aim of this study was to analyze the radiation usage in patients undergoing pulmonary vein isolation (PVI) in Germany and to evaluate the possibility to reduce radiation dose.
Methods and results
A total of 6617 patients with atrial fibrillation (AF) from the German ablation registry and the FREEZEplus registry (control
group), who underwent first PVI between 2007 and 2014, were analyzed. In the second step, the effect of optimized conventional fluoroscopy and optimized 3D mapping use was evaluated in 526 consecutive patients with AF who underwent first PVI at the Klinikum Ludwigshafen (optimized
group) between 2007 and 2014. In the control
group, the median dose area product (DAP) for PVI was 34 Gy cm2, and the median DAP rate was 1.3 Gy cm2/min. The DAP decreased from 37 to 28 Gy cm2, whereas the DAP rate increased from 1.3 to 1.6 Gy cm2/min between 2007 and 2014. In the optimized
group, optimized radiation application and use of 3D mapping resulted in a continuous decrease in the DAP from 67 to 2 Gy cm2 and DAP rate from 1.0 to 0.2 Gy cm2/min.
Conclusion
Currently, the median radiation exposure during PVI in Germany is 28 Gy cm2. Optimized fluoroscopy by simple means can safely reduce the radiation dose to about 2 Gy cm2 or even lower when using 3D mapping. Before introducing novel expensive technologies for radiation reduction optimizing of the conventional fluoroscopy is mandatory.