Development of radiation exposure in patients undergoing pulmonary vein isolation in Germany between 2007 and 2014: great potential to minimize radiation dosage
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Development of radiation exposure in patients undergoing pulmonary vein isolation in Germany between 2007 and 2014: great potential to minimize radiation dosage. / Kleemann, Thomas; Brachmann, Johannes; Lewalter, Thorsten; Andresen, Dietrich; Willems, Stephan; Spitzer, Stefan G; Hoffmann, Ellen; Eckardt, Lars; Hochadel, Matthias; Senges, Jochen; Kuck, Karl-Heinz; Seidl, Karlheinz; Zahn, Ralf.
In: CLIN RES CARDIOL, Vol. 105, No. 10, 10.2016, p. 858-864.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Development of radiation exposure in patients undergoing pulmonary vein isolation in Germany between 2007 and 2014: great potential to minimize radiation dosage
AU - Kleemann, Thomas
AU - Brachmann, Johannes
AU - Lewalter, Thorsten
AU - Andresen, Dietrich
AU - Willems, Stephan
AU - Spitzer, Stefan G
AU - Hoffmann, Ellen
AU - Eckardt, Lars
AU - Hochadel, Matthias
AU - Senges, Jochen
AU - Kuck, Karl-Heinz
AU - Seidl, Karlheinz
AU - Zahn, Ralf
PY - 2016/10
Y1 - 2016/10
N2 - 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 cm(2), and the median DAP rate was 1.3 Gy cm(2)/min. The DAP decreased from 37 to 28 Gy cm(2), whereas the DAP rate increased from 1.3 to 1.6 Gy cm(2)/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 cm(2) and DAP rate from 1.0 to 0.2 Gy cm(2)/min.CONCLUSION: Currently, the median radiation exposure during PVI in Germany is 28 Gy cm(2). Optimized fluoroscopy by simple means can safely reduce the radiation dose to about 2 Gy cm(2) or even lower when using 3D mapping. Before introducing novel expensive technologies for radiation reduction optimizing of the conventional fluoroscopy is mandatory.
AB - 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 cm(2), and the median DAP rate was 1.3 Gy cm(2)/min. The DAP decreased from 37 to 28 Gy cm(2), whereas the DAP rate increased from 1.3 to 1.6 Gy cm(2)/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 cm(2) and DAP rate from 1.0 to 0.2 Gy cm(2)/min.CONCLUSION: Currently, the median radiation exposure during PVI in Germany is 28 Gy cm(2). Optimized fluoroscopy by simple means can safely reduce the radiation dose to about 2 Gy cm(2) or even lower when using 3D mapping. Before introducing novel expensive technologies for radiation reduction optimizing of the conventional fluoroscopy is mandatory.
KW - Aged
KW - Atrial Fibrillation/diagnostic imaging
KW - Catheter Ablation/adverse effects
KW - Female
KW - Fluoroscopy
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Phlebography/adverse effects
KW - Pulmonary Veins/diagnostic imaging
KW - Radiation Dosage
KW - Radiation Exposure/adverse effects
KW - Radiation Injuries/etiology
KW - Radiography, Interventional/adverse effects
KW - Registries
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1007/s00392-016-0994-9
DO - 10.1007/s00392-016-0994-9
M3 - SCORING: Journal article
C2 - 27142281
VL - 105
SP - 858
EP - 864
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 10
ER -