Radiation peak skin dose to risk stratify electrophysiological procedures for deterministic skin damage


Paisey, J.R., Yue, A.M., White, A., Moss, A., Morgan, J.M. and Roberts, P.R. (2004) Radiation peak skin dose to risk stratify electrophysiological procedures for deterministic skin damage. The International Journal of Cardiovascular Imaging, 20, (4), 285-288. (doi:10.1023/B:CAIM.0000041943.73199.d3).

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Description/Abstract

Ionising radiation is has the potential to cause harm both by increasing the probability future malignancy (stochastic mechanisms) and by direct physical injury (deterministic mechanisms). Several measures have been developed to quantify radiation exposure during a procedure and cardiologists usually refer to fluoroscopic screening time (FST). FST, however, has limitations for predicting deterministic injury which is directly dependant on peak skin dose (PSD). We compared FST to PSD for a range of interventional cardiac electrophysiology procedures.

Methods: All patients undergoing electrophysiology procedures during a 2-month period in our institution were studied. Demographic details, nature of procedure, FST and PSD were measured. The FST to PSD ratio was calculated and compared between patient and procedural factors.

Results: 67 procedures on patients (23 female) with body mass index (BMI) of 28 (SD 5)Kg/m2 were studied. Screening times ranged from 0.2 to 96.6 min (median 11.2). PSD ranged from <0.1 to 1108 mGy (median 141). There was a positive correlation between PSD to FST ratio and BMI (r= 0.59, p < 0.001). The PSD to FST ratio was higher in cardiac resynchronization therapy (CRT) devices than single or dual chamber ICDs (p= 0.002).

Conclusion: FST is not a reliable predictor of deterministic skin injury and in high-risk procedures such as CRT devices and those on individuals of high BMI PSD should be measured.

Item Type: Article
ISSNs: 1569-5794 (print)
Related URLs:
Keywords: cardiac resynchronisation therapy, catheter ablation, fluoroscopy, implantable cardioverter defibrillator, ionising radiation
Subjects: T Technology > T Technology (General)
R Medicine > R Medicine (General)
Q Science > QC Physics
Divisions: University Structure - Pre August 2011 > School of Medicine > Developmental Origins of Health and Disease
ePrint ID: 25873
Date Deposited: 20 Apr 2006
Last Modified: 27 Mar 2014 18:14
URI: http://eprints.soton.ac.uk/id/eprint/25873

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