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Updated: Jun 19, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Radiation exposure to patients' skin during cardiac resynchronization therapy
Shigeru Suzuki1, Shigeru Furui, Takeshi Yamakawa
1Department of Radiology, Teikyo University School of Medicine, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan. s-suzuki@med.teikyo-u.ac.jp
Aims:
The purpose of the current study is to evaluate the patients' entrance skin dose (ESD) during cardiac resynchronization therapy (CRT).
Methods And Results:
Entrance skin doses were assessed during 16 CRT procedures. Seven of the 16 patients were upgrade of conventional pacemaker to CRT. The patients wore jackets which had 100 radiosensitive indicators placed on the back during the procedures. After the procedure, the patients' ESDs were calculated from the colour difference of the indicators. Eleven of the 16 patients were implanted devices with a defibrillator, and three patients those without a defibrillator. In the other two, the procedures failed. The average total fluoroscopic time (TFT), total numbers of cine frames, and the maximum ESDs were 56.7 +/- 28.0 min, 674 +/- 342 frames, and 1.0 +/- 0.6 Gy, respectively. Of the 16 patients, six received ESDs exceeding 1 Gy, TFT, total number of cine frames, and the maximum ESD tended to decrease as the operator experience increased.
Conclusion:
The patients' ESDs during CRT procedures can exceed the thresholds for radiation skin injuries due to prolonged fluoroscopic times. Therefore, interventionalists should estimate the doses.
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