Radiation exposure during radiofrequency catheter ablation for atrial fibrillation

RF catheter ablation of paroxysmal atrial fibrillation (PAF) is associated with prolonged fluoroscopy. The procedural duration and fluoroscopic exposure to patients and medical staff were recorded and compared among 43 ablation procedures for PAF, 20 for common atrial flutter, and 16 for accessory pathways. Patient radiation exposure was measured by dosimeters placed over the xyphoid, while that of physicians and nurses was measured by dosimeters placed outside and inside the lead apron. The mean fluoroscopy time was 57 +/- 30 minutes for PAF, 20 +/- 10 minutes for common flutter, and 22 +/- 21 minutes for accessory pathway ablation. The patient median radiation exposure was 1110 microSv for PAF, compared with 500 microSv for common flutter and 560 microSv for accessory pathway ablation (P < 0.01). The median radiation exposure to physician and nurse inside the lead apron were, respectively, 2 microSv and 3 microSv for PAF, 1 microSv and 2 microSv for common flutter, and < 0.5 microSv and 3 microSv for accessory pathway ablations. RF catheter ablation for PAF was associated with prolonged fluoroscopy times and a twofold higher radiation exposure to the patient and physician compared with other ablation procedures. Assuming 300 procedures/year, radiation exposure to the medical staff was below the upper recommended annual dose limit.