touchCARDIO touchCARDIO
Arrhythmia
Read Time: 2 mins

188/A new near-zero fluoroscopy technique for cardiac electronic device implantation – A validation study

Copy Link
Published Online: Oct 3rd 2008 European Journal of Arrhythmia & Electrophysiology. 2019;5(Suppl. 1):abstr188
Authors: A Creta (Presenting Author) – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; M Finlay – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; M Dhinoja – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; R Providencia – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; C Monkhouse – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; S Sporton – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; A Chow – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; MJ Earley – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; RJ Hunter – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; M Lowe – Barts Heart Centre, St Bartholomew’s Hospital, London, UK;A Muthumala – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; PD Lambiase – Barts Heart Centre, St Bartholomew’s Hospital, London, UK; RJ Schilling – Barts Heart Centre, St Bartholomew’s Hospital, London, UK
Quick Links:
Article
Article Information
Article:

Introduction: There is growing concern regarding radiation hazards for both patients and staff. The aim of this study was to investigate the efficacy and safety of a new low-dose fluoroscopy technique for cardiac electronic device implantation, and compare it with a conventional approach.

Methods:
Low-dose fluoroscopy technique: Radiation exposure during fluoroscopy is directly proportional to the time the unit is activated. Traditionally, the fluoroscopist keeps his foot on the pedal switch for at least a few seconds, in order to visualize the “live” movements of either the leads during their positioning or the needle during a fluoroscopy-guided puncture of the subclavian vein. Our technique consists of setting a low frame rate per second (range 0.5–3.75 fps) and pressing the fluoroscopy foot pedal switch for a fraction of second only. This obtains screenshots of the position of the leads/needle.

Study design: This validation study consisted of 66 consecutive patients undergoing permanent pacemaker (PPM) or cardiac defibrillator (ICD) implant in our centre from July to May 2019 using the above-described technique. Cumulative radiation dose was measured using dose-area product (DAP). Rates of success and complications were assessed at 30 days. The procedural details and outcomes were compared with a matched-cohort of patients with PPM or ICD implanted in our centre by senior operators, using a traditional fluoroscopic approach, from March 2018.

Results: A PPM or ICD was successfully implanted in all patients. Fluoroscopy time and DAP were significantly lower in the low-dose fluoroscopy group, mean 1.9 ± 1.7 seconds versus 216 ± 212.7 seconds (p<0.001) and 3.4 ± 2.4 µGym2 versus 31.9 ± 30.6 µGym2 (p<0.001), respectively. Mean procedure time was 45.3 ± 14.7 minutes in the low fluoroscopy group and 55.7 ± 28.3 minutes in the control group (p=0.048). Median frame per second setting was 0.5 in the low-dose cohort. At 30 days, there was one lead displacement in each group.

Conclusion: This new near-zero dose fluoroscopy technique is safe and allows a significant reduction of the radiation exposure during PPM and ICD implantation compared to a traditional approach.

 

Further Resources

Share this Article
Related Content In Arrhythmia
  • Copied to clipboard!
    accredited arrow-down-editablearrow-downarrow_leftarrow-right-bluearrow-right-dark-bluearrow-right-greenarrow-right-greyarrow-right-orangearrow-right-whitearrow-right-bluearrow-up-orangeavatarcalendarchevron-down consultant-pathologist-nurseconsultant-pathologistcrosscrossdownloademailexclaimationfeedbackfiltergraph-arrowinterviewslinkmdt_iconmenumore_dots nurse-consultantpadlock patient-advocate-pathologistpatient-consultantpatientperson pharmacist-nurseplay_buttonplay-colour-tmcplay-colourAsset 1podcastprinter scenerysearch share single-doctor social_facebooksocial_googleplussocial_instagramsocial_linkedin_altsocial_linkedin_altsocial_pinterestlogo-twitter-glyph-32social_youtubeshape-star (1)tick-bluetick-orangetick-red tick-whiteticktimetranscriptup-arrowwebinar Sponsored Department Location NEW TMM Corporate Services Icons-07NEW TMM Corporate Services Icons-08NEW TMM Corporate Services Icons-09NEW TMM Corporate Services Icons-10NEW TMM Corporate Services Icons-11NEW TMM Corporate Services Icons-12Salary £ TMM-Corp-Site-Icons-01TMM-Corp-Site-Icons-02TMM-Corp-Site-Icons-03TMM-Corp-Site-Icons-04TMM-Corp-Site-Icons-05TMM-Corp-Site-Icons-06TMM-Corp-Site-Icons-07TMM-Corp-Site-Icons-08TMM-Corp-Site-Icons-09TMM-Corp-Site-Icons-10TMM-Corp-Site-Icons-11TMM-Corp-Site-Icons-12TMM-Corp-Site-Icons-13TMM-Corp-Site-Icons-14TMM-Corp-Site-Icons-15TMM-Corp-Site-Icons-16TMM-Corp-Site-Icons-17TMM-Corp-Site-Icons-18TMM-Corp-Site-Icons-19TMM-Corp-Site-Icons-20TMM-Corp-Site-Icons-21TMM-Corp-Site-Icons-22TMM-Corp-Site-Icons-23TMM-Corp-Site-Icons-24TMM-Corp-Site-Icons-25TMM-Corp-Site-Icons-26TMM-Corp-Site-Icons-27TMM-Corp-Site-Icons-28TMM-Corp-Site-Icons-29TMM-Corp-Site-Icons-30TMM-Corp-Site-Icons-31TMM-Corp-Site-Icons-32TMM-Corp-Site-Icons-33TMM-Corp-Site-Icons-34TMM-Corp-Site-Icons-35TMM-Corp-Site-Icons-36TMM-Corp-Site-Icons-37TMM-Corp-Site-Icons-38TMM-Corp-Site-Icons-39TMM-Corp-Site-Icons-40TMM-Corp-Site-Icons-41TMM-Corp-Site-Icons-42TMM-Corp-Site-Icons-43TMM-Corp-Site-Icons-44TMM-Corp-Site-Icons-45TMM-Corp-Site-Icons-46TMM-Corp-Site-Icons-47TMM-Corp-Site-Icons-48TMM-Corp-Site-Icons-49TMM-Corp-Site-Icons-50TMM-Corp-Site-Icons-51TMM-Corp-Site-Icons-52TMM-Corp-Site-Icons-53TMM-Corp-Site-Icons-54TMM-Corp-Site-Icons-55TMM-Corp-Site-Icons-56TMM-Corp-Site-Icons-57TMM-Corp-Site-Icons-58TMM-Corp-Site-Icons-59TMM-Corp-Site-Icons-60TMM-Corp-Site-Icons-61TMM-Corp-Site-Icons-62TMM-Corp-Site-Icons-63TMM-Corp-Site-Icons-64TMM-Corp-Site-Icons-65TMM-Corp-Site-Icons-66TMM-Corp-Site-Icons-67TMM-Corp-Site-Icons-68TMM-Corp-Site-Icons-69TMM-Corp-Site-Icons-70TMM-Corp-Site-Icons-71TMM-Corp-Site-Icons-72