Radiation Exposure During Catheter Ablation of Atrial Fibrillation
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- Lars Lickfett
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Mahadevappa Mahesh
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Chandra Vasamreddy
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- David Bradley
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Vinod Jayam
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Zayd Eldadah
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Timm Dickfeld
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Deborah Kearney
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Darshan Dalal
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Berndt Lüderitz
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Ronald Berger
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
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- Hugh Calkins
- From the Division of Cardiology (L.L., C.V., D.B., V.J., Z.E., T.D., D.D., R.B., H.C.) and the Department of Radiology and Radiological Science (M.M., D.K.), The Johns Hopkins Hospital, Baltimore, Md, and the Department of Medicine-Cardiology, University of Bonn, Bonn, Germany (L.L., B.L.).
Description
<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> The purpose of this study was to determine the radiation exposure during catheter ablation of atrial fibrillation (AF) using the pulmonary vein (PV) approach. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> The study included 15 patients with AF and 5 patients each with atrial flutter and atrioventricular nodal reentrant tachycardia (AVNRT) who underwent fluoroscopically guided procedures on a biplane x-ray system operated at a low-frame pulsed fluoroscopy (7.5 frames per second). Radiation exposure was measured directly with 50 to 60 thermoluminescent dosimeters (TLDs). Peak skin doses (PSDs), effective radiation doses, and risk of fatal malignancies were all computed. Mean fluoroscopy durations for AF procedures were 67.8±21 minutes in the right anterior oblique (RAO) and 61.9±16.6 minutes in the left anterior oblique (LAO) projection, significantly different from that required for atrial flutter and AVNRT. The mean PSDs measured with the TLDs were 1.0±0.5 Gy in the RAO and 1.5±0.4 Gy in the LAO projection. The lifetime risk of excess fatal malignancies normalized to 60 minutes of fluoroscopy was 0.07% for women and 0.1% for men. </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> The relatively small amounts of the patient’s radiation exposure in this study, despite the prolonged fluoroscopy durations, can be attributed to the use of very-low-frame pulsed fluoroscopy, the avoidance of magnification, and optimal adjustments of the fluoroscopy exposure rates. The resulting lifetime risk of fatal malignancy is within the range previously reported for standard supraventricular arrhythmias. </jats:p>
Journal
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- Circulation
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Circulation 110 (19), 3003-3010, 2004-11-09
Ovid Technologies (Wolters Kluwer Health)
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Details 詳細情報について
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- CRID
- 1362825893830081920
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- ISSN
- 15244539
- 00097322
- http://id.crossref.org/issn/00097322
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- Data Source
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- Crossref