X-ray dose and associated risks from radiofrequency catheter ablation procedures
X-ray dose and associated risks from radiofrequency catheter ablation procedures
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DOI：
10.1259/bjr.75.891.750253
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发表时间：
2002-03-01
影响因子：
2.6
通讯作者：
Shepherd, PH
中科院分区：
文献类型：
--
作者：
McFadden, SL;Mooney, RB;Shepherd, PH
本研究的目的是量化射频（RF）导管消融术期间患者和操作员的电离辐射暴露，并估计与该暴露相关的风险。该研究包括50例射频消融术，均在同一电生理实验室进行。职业剂量的两个心脏病专家谁执行的程序进行了测量，使用电影徽章和肢体热释光剂量计（TLD）。使用TLD测量患者皮肤的吸收剂量。还测量了剂量-面积乘积（DAP）。心脏病专家的有效剂量小于0.15 mSv/月。每次射频消融术，心脏病专家左手和前额的平均等效剂量分别为0.24 mSv和0.05 mSv，是该中心进行的其他心脏病学手术平均剂量的两倍多。心内科医师的年职业剂量远低于相关的法定剂量限值。患者的平均皮肤剂量、透视时间和DAP分别为0.81戈伊、67 min和123 Gycm（2），最大值分别为3.2戈伊、2164 min和430 Gycm（2）。患者的平均有效剂量为17 mSv，其中发生致命癌症的额外风险为0.1%。6例患者（12%）接受的皮肤剂量高于放射性皮肤损伤的阈值剂量（2戈伊），但未报告皮肤损伤。患者皮肤剂量和DAP密切相关，这允许DAP用于实时监测患者皮肤剂量。DAP水平在当地被采纳为诊断参考水平（DRL），在手术过程中提供患者存在确定性皮肤损伤风险的指示。
The objectives of this study were to quantify the ionizing radiation exposure to patient and operator during radiofrequency (RF) catheter ablation and to estimate the risks associated with this exposure. The study consisted of 50 RF ablation procedures, all performed in the same electrophysiology laboratory. Occupational dose to two cardiologists who performed the procedures was measured using film badges and extremity thermoluminescent dosemeters (TLDs). Absorbed dose to the patients' skin was measured using TLDs. Dose-area product (DAP) was also measured. The effective dose to the cardiologists was less than 0.15 mSv per month. The mean equivalent dose to the cardiologists' left hand and forehead was 0.24 mSv and 0.05 mSv, respectively, per RF ablation procedure, which was more than twice the mean dose for the other cardiology procedures carried out in the centre. Yearly occupational dose to the cardiologists was much lower than the relevant statutory dose limits. The mean skin dose, fluoroscopy time and DAP to patients were 0.81 Gy, 67 min and 123 Gycm(2), respectively, with a maximum of 3.2 Gy, 2 164 minutes and 430 Gycm(2), respectively. Mean effective dose to patients was 17 mSv, from which the excess risk of developing fatal cancer is 0.1%. Six of the patients (12%) received a skin dose above the threshold dose for radiation skin injury (2 Gy), but no skin injuries were reported. Patient skin dose and DAP were closely correlated and this allows DAP to be used to monitor patient skin dose in real-time. DAP levels were locally adopted as diagnostic reference levels (DRLs) that provide an indication during a procedure that a patient is at risk of suffering deterministic skin injury.