308 Comparison of Occupational Dose Levels during Traditional Right Ventricular, His Bundle and Biventricular Pacemaker Insertion

Abstract

Background Pacemakers are implantable devices to sense and correct bradyarrhythmias. Recently there has been a move towards His bundle pacing(HBP) due to the potential improvement of clinical outcomes. There is a lack of literature examining the occupational dose implications of different pacing sites. Methods Radiation dose to the head of the operator, scrub, and scout nurse was measured in a prospective single-centre, observational study including PPM, HBP, and ICD (including CRT-D). Quantitative variables were compared using nonparametric tests (Friedman’s test and Wilcoxon’s test). Results Dose to staff and patients were highest during ICD implantations, and reached statistical significance when compared to other procedures for the scout(p=0.046), but demonstrated practical relevance to the cardiologist and scrub nurse. HBP resulted in a non-significant lower dose to the operator and scout nurse compared to RV pacing, but increased dose to the scrub nurse(p=0.063) and patient DAP(p=0.039).When the entire sample was considered, there was a statistically significant effect demonstrated for staff role(p=0.002) with the dose levels in descending order dr>scrub>scout. Pt BMI was shown to influence levels of dose (DAP and AK) to the patient(p=0.000) as well as to scrub and scout nurses(p=0.000) more so than operators.PtdoseDAP(Gy.cm2)AK(Gy/min)PPM 3.8 0.0415HBP 14 0.01ICD 28.62 0.198. Conclusion ICD insertion results in higher levels of staff and patient dose when compared to traditional PPM and HBP. Patient BMI influences occupational dose to nurses more than cardiologists. Staff role was significantly associated with occupational dose (p=0.002) with the dose levels in order dr>scrub>scout.