Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures

Abstract Background Fluoroscopic imaging involves exposure of the patients and the laboratory staff to ionizing radiation. One of the strategies that reduce such exposure in an electrophysiology laboratory is using a three‐dimensional electroanatomic mapping (3D EAM) system for performing these proc...

Full description

Bibliographic Details
Main Authors: Muzaffar Ali, Deepak Padmanabhan, Khalil Kanjwal, Milan Kumar Ghadei, Anju Kottayan, Bharatraj Banavalikar, Jayaprakash Shenthar
Format: Article
Language:English
Published: Wiley 2021-02-01
Series:Journal of Arrhythmia
Subjects:
Online Access:https://doi.org/10.1002/joa3.12496
_version_ 1818620441700335616
author Muzaffar Ali
Deepak Padmanabhan
Khalil Kanjwal
Milan Kumar Ghadei
Anju Kottayan
Bharatraj Banavalikar
Jayaprakash Shenthar
author_facet Muzaffar Ali
Deepak Padmanabhan
Khalil Kanjwal
Milan Kumar Ghadei
Anju Kottayan
Bharatraj Banavalikar
Jayaprakash Shenthar
author_sort Muzaffar Ali
collection DOAJ
description Abstract Background Fluoroscopic imaging involves exposure of the patients and the laboratory staff to ionizing radiation. One of the strategies that reduce such exposure in an electrophysiology laboratory is using a three‐dimensional electroanatomic mapping (3D EAM) system for performing these procedures. In this analysis, we have analyzed the effect of fluoroscopy frame rate on the radiation exposure and in‐hospital outcomes in ablation procedures performed under 3D EAM guidance. Methods We retrospectively analyzed all the ablation procedures performed under 3D EAM guidance at our institute from September 2015 to December 2018. The procedures were divided into two groups based on whether the procedures were performed before (pre) or after (post) January 26, 2018. After January 2018, fluoroscopy was used at a frame rate of 3.75 frames per second (fps). Radiation exposure indices and in‐hospital outcomes were compared between the two groups. Results Ablation procedures included in the analysis were ventricular arrhythmias (n = 192), atrial flutter (115), atrial tachycardia (AT) (43), and atrial fibrillation (AF) (30). Over the study period, there was a significant reduction in procedure time, fluoroscopy time, dose area product, and effective dose (ED) (P < .001). Except for AT and AF ablation procedures, there was a significant reduction in the radiation exposure indices when the “post” group was compared with the “pre” group (P ≤ .02). The decrease in the frame rate had no significant effect on in‐hospital outcomes. Conclusion The use of 3D EAM combined with decreasing the fluoroscopy frame rate significantly reduced the total radiation exposure without adversely affecting in‐hospital outcomes.
first_indexed 2024-12-16T17:53:26Z
format Article
id doaj.art-068ff5c82dee4776b9d3607806b3eac1
institution Directory Open Access Journal
issn 1880-4276
1883-2148
language English
last_indexed 2024-12-16T17:53:26Z
publishDate 2021-02-01
publisher Wiley
record_format Article
series Journal of Arrhythmia
spelling doaj.art-068ff5c82dee4776b9d3607806b3eac12022-12-21T22:22:13ZengWileyJournal of Arrhythmia1880-42761883-21482021-02-013719710210.1002/joa3.12496Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided proceduresMuzaffar Ali0Deepak Padmanabhan1Khalil Kanjwal2Milan Kumar Ghadei3Anju Kottayan4Bharatraj Banavalikar5Jayaprakash Shenthar6Department of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore IndiaDepartment of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore IndiaDepartment of Cardiology Division of Clinical Cardiac Electrophysiology McLaren Greater Lansing Hospital Lansing MI USADepartment of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore IndiaDepartment of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore IndiaDepartment of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore IndiaDepartment of Cardiac Electrophysiology Sri Jayadeva Institute of Cardiovascular Sciences and Research Bangalore IndiaAbstract Background Fluoroscopic imaging involves exposure of the patients and the laboratory staff to ionizing radiation. One of the strategies that reduce such exposure in an electrophysiology laboratory is using a three‐dimensional electroanatomic mapping (3D EAM) system for performing these procedures. In this analysis, we have analyzed the effect of fluoroscopy frame rate on the radiation exposure and in‐hospital outcomes in ablation procedures performed under 3D EAM guidance. Methods We retrospectively analyzed all the ablation procedures performed under 3D EAM guidance at our institute from September 2015 to December 2018. The procedures were divided into two groups based on whether the procedures were performed before (pre) or after (post) January 26, 2018. After January 2018, fluoroscopy was used at a frame rate of 3.75 frames per second (fps). Radiation exposure indices and in‐hospital outcomes were compared between the two groups. Results Ablation procedures included in the analysis were ventricular arrhythmias (n = 192), atrial flutter (115), atrial tachycardia (AT) (43), and atrial fibrillation (AF) (30). Over the study period, there was a significant reduction in procedure time, fluoroscopy time, dose area product, and effective dose (ED) (P < .001). Except for AT and AF ablation procedures, there was a significant reduction in the radiation exposure indices when the “post” group was compared with the “pre” group (P ≤ .02). The decrease in the frame rate had no significant effect on in‐hospital outcomes. Conclusion The use of 3D EAM combined with decreasing the fluoroscopy frame rate significantly reduced the total radiation exposure without adversely affecting in‐hospital outcomes.https://doi.org/10.1002/joa3.12496atrial fluttereffective doseradiation exposurethree‐dimensional electroanatomic mappingventricular tachycardia
spellingShingle Muzaffar Ali
Deepak Padmanabhan
Khalil Kanjwal
Milan Kumar Ghadei
Anju Kottayan
Bharatraj Banavalikar
Jayaprakash Shenthar
Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures
Journal of Arrhythmia
atrial flutter
effective dose
radiation exposure
three‐dimensional electroanatomic mapping
ventricular tachycardia
title Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures
title_full Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures
title_fullStr Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures
title_full_unstemmed Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures
title_short Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures
title_sort effect of fluoroscopy frame rate on radiation exposure and in hospital outcomes in three dimensional electroanatomic mapping guided procedures
topic atrial flutter
effective dose
radiation exposure
three‐dimensional electroanatomic mapping
ventricular tachycardia
url https://doi.org/10.1002/joa3.12496
work_keys_str_mv AT muzaffarali effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures
AT deepakpadmanabhan effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures
AT khalilkanjwal effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures
AT milankumarghadei effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures
AT anjukottayan effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures
AT bharatrajbanavalikar effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures
AT jayaprakashshenthar effectoffluoroscopyframerateonradiationexposureandinhospitaloutcomesinthreedimensionalelectroanatomicmappingguidedprocedures