Radiation doses to patients and cardiologists from permanent cardiac pacemaker implantation procedures

The purpose of this study was to determine the patient and cardiologist doses during the implantation of permanent cardiac pacemakers under fluoroscopic control.

For 55 procedures concerning three different types of pacemakers (DDD, VDD, and VVI), the dose-area product (DAP) meter readings and fluoroscopy times were recorded. From these data, the dose to the operating cardiologist was estimated.

The median values of DAP and fluoroscopy time for all the procedures monitored were 11.4 Gycm(2) and 6.6 minute, respectively. For the 22 DDD, 21 VDD, and 12 VVI pacemakers implanted, the respective DAP median values were 14.7, 9.9, and 7.3 Gycm(2) and the respective median fluoroscopy times were 8.4, 5, and 2.9 minutes. The median doses to the hands, chest, eyes, and legs of the cardiologist conducting the manipulations were estimated to 0.21, 0.06, 0.03, and 0.11 mGy, respectively, per procedure.

Compared to the existing literature, the median DAP value of this study is almost identical to the 11.2 Gycm(2) reported from a sample of 627 patients in 17 different x-ray rooms, whereas the fluoroscopy times are within the range of values reported by other authors. Concerning the cardiologist exposure, the estimated values indicate that the implantation of pacemakers is a procedure that does not involve a severe risk, especially if it is taken into account that lead aprons and collars are routinely used.