心房細動のカテーテルアブレーション中の放射線被曝
Lars Lickfett1, Mahadevappa Mahesh, Chandra Vasamreddy
1Division of Cardiology, The Johns Hopkins Hospital, Baltimore, Md, USA.
Circulation
|October 27, 2004
まとめ
この研究では,肺静脈 (PV) 隔離を用いた心房細動 (AF) の低放射線カテーテル除去が,患者の放射線曝露を最小限に抑えることを発見しました. 最適化された光検査技術はリスクを最小限に抑え,悪性腫瘍のリスクを以前報告された範囲内に保ちます.
科学分野:
- 心臓病学 心臓病学
- メディカルイマージング (医学イメージング)
- 放射線腫瘍学 放射線腫瘍学
背景:
- カテーテルアブレーションは,心房細動 (AF) のような心律不整症の一般的な治療法です.
- 光学的に導かれた処置は,患者の放射線被曝を注意深く監視することを必要とします.
- 放射線用量の最適化は,電気生理学的処置中の患者の安全性にとって極めて重要です.
研究 の 目的:
- 肺静脈 (PV) アプローチを用いて,心房細動 (AF) のキャセターアブレーション中の患者の放射線被曝量を定量化するために.
- AF除去中に放射線被曝を減らすための低用量光学技術の安全性と有効性を評価する.
主な方法:
- AFの15人の患者は,二平面X線システムを使用して,光学的に導かれたカテーテル除去を受けた.
- 低フレームパルス式光鏡 (7.5fps) と最適化された曝露率を使用した.
- 放射線用量は,ピーク皮膚用量 (PSD) と有効放射線用量を決定するために50〜60の熱発光用量計 (TLD) を使用して測定されました.
主要な成果:
- AFの手続きの平均光検査時間は67.8分 (RAO) と61.9分 (LAO) でした.
- 平均PSDは1.0 Gy (RAO) と1.5 Gy (LAO) でした.
- 致死性悪性腫瘍の生涯リスクは,フルオロスコーピーの60分ごとに,女性では0.07%,男性では0.1%であった.
結論:
- 低フレームパルス式光鏡検査,拡大を回避し,最適化された曝露率により,AF除去中に患者の放射線曝露を大幅に軽減します.
- 放射線用量および関連するリスクは,他の心室内外動脈動乱症について報告されたものと同等です.
- これらの発見は,カテーテル除去の手続きにおいて,最適化された光技術の使用の安全性を支持しています.
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