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Radiation Peak Skin Dose to Risk Stratify Electrophysiological Procedures for Deterministic Skin Damage

Authors
  • Paisey, J.R.1
  • Yue, A.M.2
  • White, A.2
  • Moss, A.2
  • Morgan, J.M.2
  • Roberts, P.R.2
  • 1 Southampton General Hospital, Tremona Road, SO16 6YD, Southampton, MRCP, Wessex Cardiothoracic Centre, United Kingdom; Tel.: +23-8079-8646; Fax: +23-8079-8942;E-mail:
  • 2 Southampton University Hospitals, Wessex Cardiothoracic Centre, UK
Type
Published Article
Journal
The International Journal of Cardiovascular Imaging
Publisher
Springer-Verlag
Publication Date
Aug 01, 2004
Volume
20
Issue
4
Pages
285–288
Identifiers
DOI: 10.1023/B:CAIM.0000041943.73199.d3
Source
Springer Nature
Keywords
License
Yellow

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.

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