Occupational hazards of interventional cardiology

Smilowitz, Nathaniel R.; Balter, Stephen; Weisz, Giora

doi:10.1016/j.carrev.2013.05.002

Cited by 66 publications

(43 citation statements)

References 86 publications

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“…The risk of radiation exposure in cardiology is well recognized for patients and as an occupational hazard for laboratory staff [6]. Medical exposure to radiation has increased in line with advancements in diagnostic imaging and is now the most significant manmade source of radiation [7].…”

Section: Discussionmentioning

confidence: 99%

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

et al. 2018

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AimsZero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs).MethodsWe retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center. The first 42 (Group 1) underwent a conventional fluoroscopic-guided approach and the second 50 (Group 2) underwent a zero-fluoroscopic approach using the Ensite Precision™ 3-D magnetic and impedance-based mapping system (Abbott Inc).ResultsGroup 1 comprised 14 AV-nodal re-entrant tachycardia (AVNRT), 12 typical atrial flutter, 4 accessory pathway (AP), 2 atrial tachycardia (AT), and 9 diagnostic EP studies (EPS). Group 2 comprised 16 AVNRT, 17 atrial flutter, 6 AP, 3 AT, 2 AV-nodal ablations, and 7 EPS. A complete zero-fluoroscopic approach was achieved in 94% of Group 2 patients. All procedures were acutely successful, and no complications occurred. There was a significant reduction in fluoroscopy dose, dose area product, and time (p < 0.0001, for all), with no difference in procedure times. Ablation time for typical atrial flutter was shorter in Group 2 (p = 0.006).ConclusionsA zero-fluoroscopic strategy for diagnosis and treatment of SVTs using this novel 3D-electroanatomical mapping system is feasible in majority of patients, is safe, reduces ionizing radiation exposure, and does not compromise procedural times, success rates, or complication rates.

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Section: Discussionmentioning

confidence: 99%

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

et al. 2018

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“…In addition to the direct health benefits of radiation reduction, there is an increasing appreciation for the long-term orthopedic effects of chronic use of heavy lead aprons by cardiac interventionalists. 16 Eliminating the need for lead reduces the risk of orthopedic injury as well as physical fatigue after multiple cases. Our technique has not been associated with any procedural complications, though only 14 patients have undergone ablation using this technique.…”

Section: Discussionmentioning

confidence: 99%

Zero-fluoroscopy Intracardiac Echocardiography-guided Ablation of Atrial Fibrillation Using a Single-catheter Technique

Montgomery¹

2015

JICRM

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ABSTRACT. Advanced electroanatomic mapping and contact force-sensing catheters have improved outcomes, increased efficiency, and significantly reduced the need for fluoroscopy during radiofrequency ablation of atrial fibrillation (AF). However, fluoroscopic guidance is still routinely used for the procedure, posing a long-term risk to the patient, the operator, and laboratory staff. Furthermore, rapid high-density mapping has diminished the need for a second multipolar or circular left atrial catheter to demonstrate electrical isolation of pulmonary veins. We describe a novel approach to AF ablation using only intracardiac echo guidance, a decapolar coronary sinus catheter, and a single ablation catheter in the left atrium. Mapping is performed using the CARTO-3 system with Confidense module (Biosense Webster, Diamond Bar, CA) to achieve and verify pulmonary vein isolation.

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“…Several well‐known potential occupational hazards related to the practice of interventional cardiology exist, including orthopedic injuries (e.g., spinal disease; back, hip, knee, and ankle pain), infectious hazards related to needle‐stick and sharp injuries, and radiation hazards . Not much attention, however, has been placed on sleep deprivation.…”

Section: Potential Impact On the Interventional Cardiologistmentioning

confidence: 99%

Sleep deprivation in interventional cardiology: Implications for patient care and physician‐health

Sandoval

Lobo

Somers

et al. 2017

Cathet Cardio Intervent

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The burden and impact of sleep deprivation on both patient care and on the health of interventional cardiologists is not well understood. Due to the nature of emergent procedures occurring in the cardiac catheterization laboratory, interventionalists are prone to suffer from acute and/or chronic sleep deprivation. Sleep deprivation has been associated with numerous adverse effects, such as impaired performance, cognitive deficits, reduced psychomotor vigilance, and workplace errors and injuries, among many others. Although sleep deprivation has been linked to more errors in trainees, there is paucity of data addressing outcomes in interventional cardiology. The purpose of this overview is to explore the possible impact of sleep deprivation on interventional cardiology in relation to patient care and physician health, and examine potential approaches to this issue.

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Occupational hazards of interventional cardiology

Cited by 66 publications

References 86 publications

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system

Zero-fluoroscopy Intracardiac Echocardiography-guided Ablation of Atrial Fibrillation Using a Single-catheter Technique

Sleep deprivation in interventional cardiology: Implications for patient care and physician‐health

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