Radiation exposure to patients and medical personnel during radiofrequency catheter ablation for supraventricular tachycardia

Abstract

Radiofrequency catheter ablation is an effective alternative to medical therapy for patients with supraventricular arrhythmias. The purpose of this study was to determine the risks to the patient and to medical personnel due to radiation exposure from fluoroscopy during radiofrequency ablation of supraventricular tachycardia. One hundred eight consecutive patients with Wolff-Parkinson-White syndrome or atrioventricular nodal reentry who underwent the ablation procedure were studied. The ablation procedure was successful in 95% of the patients studied. Preexcitation or supraventricular tachycardia recurred in 5% of the patients during a mean follow-up of 9 +/- 4 months. The mean fluoroscopy time was 50 +/- 31 minutes. An anthropomorphic radiologic phantom was used to determine organ exposure and the effective dose equivalents for the patient and medical personnel. The patient's effective dose equivalent during a representative ablation procedure was 1.7 rems, which is comparable to other invasive cardiovascular procedures. The risk of inducing a fatal cancer from this exposure is 1 chance in 745, which is 1% of the spontaneous risk. The risk of a serious birth defect is 1 chance in 80,000, which is 0.1% of the current incidence of serious birth defects in the United States. The cardiologist who receives the highest exposure among medical personnel, would incur 1.8 mrems per case or 450 mrems per year if 250 procedures were performed. This exposure is 9% of the recommended annual limit. These results demonstrate the efficacy of radiofrequency energy ablation of supraventricular tachycardia and confirm that radiation exposure to patients and medical personnel is within established guidelines.