Evaluation of a radiation protection cabin for invasive electrophysiological procedures

Dragusin, Octavian; Weerasooriya, Rukshen; Jaı̈s, Pierre; Hocini, Mélèze; Ector, Joris; Takahashi, Yoshihide; Haı̈ssaguerre, Michel; Bosmans, Hilde; Heidbüchel, Hein

doi:10.1093/eurheartj/ehl420

Cited by 80 publications

(46 citation statements)

References 20 publications

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“…ZeroGravity differs from other weightless lead-apron substitutes by combining additional head shielding, rapid sterile entry/exit, and overhead suspension allowing body motion without floor-base motion [24,25]. The LAS technique, the most broadly studied protection method, is limited by difficulty maintaining ideal shielding position during interventional procedures, and the barrier discontinuity of multiple, separate devices [1,5,6,[18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Suspended Personal Radiation Protection System vs. Conventional Apron and Shields in Clinical Interventional Procedures

Savage¹,

Seale²,

Shaw³

et al. 2013

OJRad

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Purpose: This clinical study compares conventional lead aprons and ancillary shields to a functionally weightless personal overhead-supported system with expanded coverage. Materials and Methods: Primary operators performed procedures (N = 126, fluoroscopy minutes = 1209) using one of 2 methods of radiation protection and wearing dosimeters on multiple body locations. Method "LAS" (Lead-Apron+Shields): lead skirt, vest, thyroid shield, with 100% use of under-table shield, side shield, and mobile suspended lead-acrylic shield. Method "Zgrav": ZeroGravity system (CFI Medical Solutions) with variable use of shielding. The studied early model moving with the operator had a curved lead-acrylic head shield (0.5 mm Pb) and expansive lead apron (0.5 -1.0 mm Pb) that covered leg to distal calf and proximal arm to elbow, and a drape that permitted sterile entry and exit. Study was institutional review board approved and HIPPA-compliant. Results: Measured with a sensitive electronic dosimeter, eye exposures were 99% (P < 0.001) reduced for Zgrav with upgraded face shield vs. LAS, regardless of use or non-use of suspended shield with Zgrav. With optically stimulated luminescence (OSL) dosimeters, operator exposures, standardized to minutes of fluoroscopy and Fluoroscopic Patient Dose Area Product, were reduced by 87% -100% for eye & head, neck, humerus, and tibia (Zgrav vs. LAS). Overall eye & head exposure reduction for entire study was 94%. Non-equivalence of torso exposures was not demonstrated. A brief user survey showed ergonomic advantages of Zgrav. Conclusion: Compared to conventional lead aprons with shields, the suspended system provided superior operator protection during interventional fluoroscopy, allowing operators to perform procedures without potentially obstructive shields.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a Suspended Personal Radiation Protection System vs. Conventional Apron and Shields in Clinical Interventional Procedures

Savage¹,

Seale²,

Shaw³

et al. 2013

OJRad

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show abstract

“…Although it is hypothesized that the use of remote navigation systems will reduce radiation exposure to patients and operators, this remains unproven. Another option to minimize radiation exposure to the operator and also to alleviate the orthopedic implications of conventional lead aprons is the use of a radioprotection cabin or a suspended lead apron (Zero Gravity) [642].…”

Section: Radiation Exposure During Catheter Ablation Of Atrial Fibrilmentioning

confidence: 99%

2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design

Calkins

Kuck

Cappato

et al. 2012

J Interv Card Electrophysiol

1,468

680

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This is a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation, developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology and the European Cardiac Arrhythmia Society (ECAS), and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). This is endorsed by the governing bodies of the ACC Foundation, the AHA, the ECAS, the EHRA, the STS, the APHRS, and the HRS.

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“…A 3D electroanatomical mapping system was not used in the manual group. The Cathpax radioprotection cabin (Lemer Pax; Carquefou, France) 11 was used to protect the operator from radiation during all the procedures in both groups.…”

Section: Catheter Ablationmentioning

confidence: 99%

Remote Magnetic Navigation With Irrigated Tip Catheter for Ablation of Paroxysmal Atrial Fibrillation

Miyazaki

Shah²,

Xhaët³

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background— The remote magnetic navigation system (MNS) has been used with a nonirrigated magnetic catheter for atrial fibrillation (AF) ablation. The objective of this study was to evaluate the feasibility and efficiency of the newly available irrigated tip magnetic catheter for index pulmonary vein isolation (PVI) in patients with paroxysmal AF (PAF). Methods and Results— Between January 2008 and June 2009, 30 consecutive patients with drug-resistant PAF underwent circular mapping catheter-guided PVI with MNS (MNS group). The outcomes were compared retrospectively with those of a conventional hand-controlled ablation technique during the same period in 44 consecutive patients (manual group). All 4 pulmonary veins were successfully isolated in both groups except in 4 patients in the MNS group. Radiofrequency and procedure duration were higher in the MNS group (60±27 versus 43±16 minutes; P =0.0019) than in the manual group (246±50 versus 153±51 minutes; P <0.0001). In the patients who underwent only PVI, total fluoroscopic time also was longer in the MNS group than in the manual group (58±24 versus 40±14 minutes; P =0.0002). At 12-month follow-up after a single procedure, 69.0% of the patients in MNS group and 61.8% of patients in manual group were free of atrial tachyarrhythmia without antiarrhythmic drugs. There was no significant difference in the atrial tachyarrhythmia-free survival between the 2 groups ( P =0.961). Cardiac tamponade occurred in 1 patient in the manual group. Conclusions— In patients with PAF, MNS-guided PVI with the newly available irrigated tip magnetic catheter backed up with manual ablation whenever required is feasible. However, it requires longer ablation, fluoroscopy, and procedural times than the conventional approach in the early experience stage.

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Evaluation of a radiation protection cabin for invasive electrophysiological procedures

Abstract: The use of the RPC allows performing catheter ablation procedures without compromising catheter manipulation, and with negligible radiation exposure for the operator.

Cited by 80 publications

References 20 publications

Evaluation of a Suspended Personal Radiation Protection System vs. Conventional Apron and Shields in Clinical Interventional Procedures

Evaluation of a Suspended Personal Radiation Protection System vs. Conventional Apron and Shields in Clinical Interventional Procedures

2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design

Remote Magnetic Navigation With Irrigated Tip Catheter for Ablation of Paroxysmal Atrial Fibrillation

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