Radiation exposure: A silent complication of catheter ablation procedures

Abstract

An underappreciated “silent complication” of catheter ablation procedures is radiation exposure. X-ray exposure results in acute complications related to dose- and time-dependent exposure as well as a cumulative, lifetime risk to not only the patient but also the operator and electrophysiology staff. These risks include acute and subacute dermatologic injury, musculoskeletal injury, cataracts, malignancy, and genetic defects. 1 Rosenthal L.S. Beck T.J. Williams J. et al. Acute radiation dermatitis following radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia. Pacing Clin Electrophysiol. 1997; 20: 1834-1839 Crossref PubMed Scopus (72) Google Scholar , 2 Kovoor P. Ricciardello M. Collins L. Uther J.B. Ross D.L. Risk to patients from radiation associated with radiofrequency ablation for supraventricular tachycardia. Circulation. 1998; 98: 1534-1540 Crossref PubMed Scopus (160) Google Scholar , 3 Perisinakis K. Damilakis J. Theocharopoulos N. Manios E. Vardas P. Gourtsoyiannis N. Accurate assessment of patient effective radiation dose and associated detriment risk from radiofrequency catheter ablation procedures. Circulation. 2001; 104: 58-62 Crossref PubMed Scopus (141) Google Scholar These risks are heightened for lengthy and multiple ablation procedures (eg, atrial fibrillation) and for vulnerable patients such as pediatric, obese, and pregnant patients. Contact force–controlled zero-fluoroscopy catheter ablation of right-sided and left atrial arrhythmia substratesHeart RhythmVol. 9Issue 5PreviewConventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. However, nonfluoroscopic catheter guidance may increase the risk for inadvertent cardiac injury. A novel radiofrequency ablation catheter capable of real-time tissue-tip contact force measurements may compensate for nonfluoroscopic safety issues. Full-Text PDF