Reducing patient radiation dosage during pediatric SVT ablations using an "aLARA" radiation reduction protocol in the modern fluoroscopic era

PACE - Pacing and Clinical Electrophysiology

Volumn 36, Issue 6, 2013, Pages 688-694

  Gellis, Laura A ^a   Ceresnak, Scott R ^a   Gates, Gregory J ^a   Nappo, Lynn ^a   Pass, Robert H ^a  

^a ALBERT EINSTEIN COLLEGE OF MEDICINE   (United States)

Author keywords

pediatrics; radiology; SVT

Indexed keywords

ABLATION THERAPY; ADOLESCENT; ADULT; ARTICLE; BODY SURFACE; BODY WEIGHT; CHILD; CHILDHOOD DISEASE; CLINICAL ARTICLE; CLINICAL PROTOCOL; FEMALE; FLUOROSCOPY; HUMAN; MALE; OUTCOME ASSESSMENT; PRESCHOOL CHILD; RADIATION DOSE; RADIATION DOSE DISTRIBUTION; RADIATION DOSE REDUCTION; RADIATION EXPOSURE; RADIATION SAFETY; RADIOLOGICAL PARAMETERS; REENTRY TACHYCARDIA; SCHOOL CHILD; STANDARD; SUPRAVENTRICULAR TACHYCARDIA; WOLFF PARKINSON WHITE SYNDROME; X RAY;

ADOLESCENT; ADULT; CATHETER ABLATION; CHILD; CHILD, PRESCHOOL; COMORBIDITY; FEMALE; FLUOROSCOPY; HUMANS; MALE; NEW YORK; PREVALENCE; RADIATION DOSAGE; RADIATION INJURIES; RADIATION PROTECTION; RADIOMETRY; RETROSPECTIVE STUDIES; SURGERY, COMPUTER-ASSISTED; TACHYCARDIA, SUPRAVENTRICULAR; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84878565896     PISSN: 01478389     EISSN: 15408159     Source Type: Journal    
DOI: 10.1111/pace.12124     Document Type: Article

References (24)

1. Balaji S,. NASPE Expert Consensus Conference: Radiofrequency catheter ablation in children with and without congenital heart disease. Report of the writing committee. North American Society of Pacing and Electrophysiology. Pacing Clin Electrophysiol 2002; 25: 1000-1017.
2. Phillips JR, Case CL,. Mapping and ablation of ventricular tachycardia in children and adolescents. Prog Pediatr Cardiol 2001; 13: 53-60.
3. Samii SM, Cohen MH,. Ablation of tachyarrhythmias in pediatric patients. Curr Opin Cardiol 2004; 19: 64-67.
4. ACC/AHA Task Force Report. Guidelines for Clinical Intracardiac Electrophysiological and Catheter Ablation Procedures. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Intracardiac Electrophysiologic and Catheter Ablation Procedures). Developed in collaboration with the North American Society of Pacing and Electrophysiology. J Cardiovasc Electrophysiol 1995; 6: 652-679.
5. Lenarczyk R, Kowalski O, Pruszkowska-Skrzep P, Pluta S, Sokal A, Lenarczyk A, Zeifert B, et al. Radiofrequency catheter ablation in the treatment of arrhythmias in children-Efficacy, safety of the method, predictors of the procedural course and acute success. Przegl Lek 2009; 66: 418-423.
6. Samara ET, Aroua A, Stauffer JC, Bochud F, Verdun FR,. Fluoroscopy-guided procedures in cardiology: Is patient exposure being reduced over time? Radiat Prot Dosimetry 2010; 139: 271-274.
7. Wagner LK, Eifel PJ, Geise RA,. Potential biological effects following high X-ray dose interventional procedures. J Vasc Interv Radiol 1994; 5: 71-84.
8. Hoffmann A, Engelfriet P, Mulder B,. Radiation exposure during follow-up of adults with congenital heart disease. Int J Cardiol 2007; 118: 151-153.
9. Ait-Ali L, Andreassi MG, Foffa I, Spadoni I, Vano E, Picano E,. Cumulative patient effective dose and acute radiation-induced chromosomal DNA damage in children with congenital heart disease. Heart 2010; 96: 269-274.
10. Justino H,. The ALARA concept in pediatric cardiac catheterization: Techniques and tactics for managing radiation dose. Pediatr Radiol 2006; 36 (Suppl 2): 146-153.
11. Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation, N.R.C., Health Risks From Exposure to Low Levels of Ionizing Radiation, BEIR VII Phase 2. Washington, DC, National Academies Press, 2006.
12. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 2007; 37: 1-332.
13. Koenig TR, Mettler FA, Wagner LK,. Skin injuries from fluoroscopically guided procedures: Part 1, characteristics of radiation injury. AJR Am J Roentgenol 2001; 177: 3-11.
14. Vano E, Ubeda C, Leyton F, Miranda P, Gonzalez L,. Staff radiation doses in interventional cardiology: Correlation with patient exposure. Pediatr Cardiol 2009; 30: 409-413.
15. Venneri L, Rossi F, Botto N, Andreassi MG, Salcone N, Emad A, Lazzeri M, et al. Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: Insights from the National Research Council's Biological Effects of Ionizing Radiation VII Report. Am Heart J 2009; 157: 118-124.
16. Kim KP, Miller DL,. Minimising radiation exposure to physicians performing fluoroscopically guided cardiac catheterisation procedures: A review. Radiat Prot Dosimetry 2009; 133: 227-233.
17. Miyake CY, Mah DY, Atallah J, Oikle HP, Melgar ML, Alexander ME, Berul CI, et al. Nonfluoroscopic imaging systems reduce radiation exposure in children undergoing ablation of supraventricular tachycardia. Heart Rhythm 2011; 8: 519-525.
18. Clark J, Bockoven JR, Lane J, Patel CR, Smith G,. Use of three-dimensional catheter guidance and trans-esophageal echocardiography to eliminate fluoroscopy in catheter ablation of left-sided accessory pathways. Pacing Clin Electrophysiol 2008; 31: 283-289.
19. Tuzcu V,. A nonfluoroscopic approach for electrophysiology and catheter ablation procedures using a three-dimensional navigation system. Pacing Clin Electrophysiol 2007; 30: 519-525.
20. Smith G, Clark JM,. Elimination of fluoroscopy use in a pediatric electrophysiology laboratory utilizing three-dimensional mapping. Pacing Clin Electrophysiol 2007; 30: 510-518.
21. Hindricks G., Willems S, Kautzner J, De Chillou C, Wiedemann M, Schepel S, Piorkowski C, et al.; Investigators. Effect of electroanatomically guided versus conventional catheter ablation of typical atrial flutter on the fluoroscopy time and resource use: A prospective randomized multicenter study. J Cardiovasc Electrophysiol 2009; 20: 734-740.
22. Sporton SC, Earley MJ, Nathan AW, Schilling RJ,. Electroanatomic versus fluoroscopic mapping for catheter ablation procedures: A prospective randomized study. J Cardiovasc Electrophysiol 2004; 15: 310-315.
23. Bodenheimer T,. High and rising health care costs. Part 2: Technologic innovation. Ann Intern Med 2005; 142: 932-937.
24. Partridge J, McGahan G, Causton S, Bowers M, Mason M, Dalby M, Mitchell A,. Radiation dose reduction without compromise of image quality in cardiac angiography and intervention with the use of a flat panel detector without an antiscatter grid. Heart 2006; 92: 507-510.