Effect of fluoroscopy frame rate on radiation exposure and in-hospital outcomes in cardiovascular implantable electronic device implantation procedures

Ali, Manzoor; Banavalikar, Bharatraj; Kanjwal, Khalil; Ghadei, Milan; Kottayan, Anju; Padmanabhan, Deepak; Shenthar, Jayaprakash

doi:10.1016/j.radmp.2021.09.003

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…To minimalize radiation exposure, there are a few approaches that can be done. The first and second methods were to reduce the time spent near the radiation source and to keep as much distance as possible, which were not very feasible for both the medical staff and the patient when fluoroscopy is performed 3 . The only available method was by shielding.…”

Section: Introductionmentioning

confidence: 99%

“…The first and second methods were to reduce the time spent near the radiation source and to keep as much distance as possible, which were not very feasible for both the medical staff and the patient when fluoroscopy is performed. 3 The only available method was by shielding. Nevertheless, even with the use of radioprotective gears, radiation exposure could only be reduced up to a thousand‐fold.…”

Section: Introductionmentioning

confidence: 99%

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Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Luke,

Milla,

Tandi

et al. 2023

Journal of Arrhythmia

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BackgroundFluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. This study compares the feasibility and safety of ZMF approach to fluoroscopy for CIEDs therapy in adults.MethodA systematic literature search was conducted on PubMed, ScienceDirect, and Web of Science in March 2023. All observational or experimental studies comparing ZMF approach to fluoroscopy for adult CIEDs therapy were included. Reviews, case report/series, animal studies, and non‐English articles were excluded. The success rate, procedural time, fluoroscopy time, radiation dose, and complications rate were compared for each approach.ResultsSeven articles for permanent and three articles for temporary CIEDs were included for analysis. The success rate of ZMF for permanent CIEDs was similar to fluoroscopy method (OR: 0.77, 95% CI: 0.33–4.15). The procedural time of ZMF was similar to fluoroscopy for both permanent and temporary CIEDs (standardized mean difference [SMD]: 0.10, 95% CI: −0.35 to 0.55 and SMD: −0.71, 95% CI: −1.87–0.44, respectively). However, ZMF approach markedly reduced the fluoroscopy time and radiation exposure for permanent CIEDs (SMD: −1.80, 95% CI: −2.49 to −1.12 and SMD: −1.26, 95% CI: −2.24 to −0.29). The complication rate was similar for permanent CIEDs (OR: 1.08, 95% CI: 0.41–2.84), yet lowered for temporary CIEDs (OR: 0.34, 95% CI: 0.20–0.59).ConclusionZMF had similar success rate, procedural time, and sum complication rate for permanent CIEDs implantation with a significant reduction of fluoroscopy time and radiation exposure.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Luke,

Milla,

Tandi

et al. 2023

Journal of Arrhythmia

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Frame-rate reduction to reduce radiation dose for cardiac device implantation is safe

et al. 2023

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Dose-area product reduction through a practice implementing low frame rate fluoroscopy and increased collimation during single-vessel percutaneous coronary interventions

Bousis,

Kosovitsas,

Karanikis

et al. 2024

Radiation Protection and Environment

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This study aims to investigate the impact of lowering fluoroscopic frame rate and increasing collimation on dose area product (DAP) during single-vessel percutaneous coronary interventions. Two patient groups that underwent such procedures were retrospectively reviewed: one treated with a standard practice employing fluoroscopy at 15 frames/s and usual collimation (standard group), and the other with a reduced practice employing fluoroscopy at 7.5 frames/s and increased collimation (reduced group). DAP, patient’s effective dose (ED), fluoroscopy time, and number of cineangiography (cine) frames were compared between groups. Multilinear analysis was performed, with DAP as a primary endpoint, to assess the impact of reduced practice in comparison to that of other variables deemed as key descriptors of radiation, patient, disease, or procedure. Relative to the standard group, the reduced group showed a significant decrease of ~37% in DAP (91.46 ± 45.08 Gy•cm2 vs. 145.23 ± 59.67 Gy•cm2, P < 0.0001) and of ~39% in ED (18.70 ± 9.00 mSv vs. 30.61 ± 12.72 mSv, P < 0.0001). While fluoroscopic time was not statistically different between groups (reduced: 10.3 ± 5.6 min vs. standard: 11.1 ± 5.3 min, P = 0.09), number of cine frames was significantly higher in the reduced (1162 ± 304 vs. 936 ± 363, P < 0.0001) due to interoperator experience variability. Multilinear analysis demonstrated that the adoption of the reduced practice was the most significant contributor to the observed DAP decrease. After adjusting for potential confounders, a reduction of ~39% in DAP was found.

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Effect of fluoroscopy frame rate on radiation exposure and in-hospital outcomes in cardiovascular implantable electronic device implantation procedures

Cited by 3 publications

References 23 publications

Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis

Frame-rate reduction to reduce radiation dose for cardiac device implantation is safe

Dose-area product reduction through a practice implementing low frame rate fluoroscopy and increased collimation during single-vessel percutaneous coronary interventions

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