Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre
AIM: To establish local diagnostic reference levels for cardiac implantable electronic device procedures and to compare local practice with national guidelines. METHODS: A retrospective cohort study including all consecutive patients from October 2018 to October 2020 who underwent implantation of...
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2025-07-01
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| Series: | Swiss Medical Weekly |
| Online Access: | https://smw.ch/index.php/smw/article/view/4053 |
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| author | Eleni Theano Samara Lorraine Sazgary Anja Stüssi Natalia Saltybaeva Matthias Guckenberger Frank Ruschitzka Thomas Wolber Nadine Molitor Daniel Hofer Fu Guan Gonca Suna Julia Hermes-Laufer Corinna B. Brunckhorst Firat Duru Alexander Breitenstein Ardan M. Saguner |
| author_facet | Eleni Theano Samara Lorraine Sazgary Anja Stüssi Natalia Saltybaeva Matthias Guckenberger Frank Ruschitzka Thomas Wolber Nadine Molitor Daniel Hofer Fu Guan Gonca Suna Julia Hermes-Laufer Corinna B. Brunckhorst Firat Duru Alexander Breitenstein Ardan M. Saguner |
| author_sort | Eleni Theano Samara |
| collection | DOAJ |
| description |
AIM: To establish local diagnostic reference levels for cardiac implantable electronic device procedures and to compare local practice with national guidelines.
METHODS: A retrospective cohort study including all consecutive patients from October 2018 to October 2020 who underwent implantation of a cardiac implantable electronic device including pacemaker, implantable cardioverter defibrillator (ICD), cardiac resynchronisation therapy (CRT) or lead extraction / device explantation. Data was collected from a dose management system and cross-checked for accuracy with the patient information system. The pre-specified outcome was patient radiation exposure, evaluated with the kerma area product (KAP), cumulative dose, fluoroscopy time and number of cine acquisitions. The median values were set as local diagnostic reference levels.
RESULTS: A total of 541 patients were included. 28.3% had a conventional pacemaker, 22.0% a leadless pacemaker, 21.1% an ICD and 17.2% a CRT implanted, while lead extraction / device explantation was performed in 11.5% of patients. The local diagnostic reference levels for the kerma area product were lower than the national Swiss diagnostic reference levels (0.4 Gray [Gy]∙cm2 vs 30 Gy∙cm2 for conventional pacemakers; 0.4 Gy∙cm2 vs 20 Gy∙cm2 for ICDs; 10.2 Gy∙cm2 vs 57 Gy cm2 for CRTs). Similarly, the local diagnostic reference levels for cumulative dose and fluoroscopy time were below national diagnostic reference levels.
CONCLUSIONS: Local diagnostic reference levels values were far below national diagnostic reference levels. A multicentre approach to assess patient radiation exposure in current practice is strongly desired to establish revised national diagnostic reference levels.
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| format | Article |
| id | doaj-art-0a4a3ca1eb684488af2ddd6c570c7b05 |
| institution | DOAJ |
| issn | 1424-3997 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj-art-0a4a3ca1eb684488af2ddd6c570c7b052025-08-20T03:12:05ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972025-07-01155710.57187/s.4053Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centreEleni Theano Samara0Lorraine Sazgary 1Anja Stüssi 2Natalia Saltybaeva 3Matthias Guckenberger 4Frank Ruschitzka 5Thomas Wolber 6Nadine Molitor 7Daniel HoferFu Guan8Gonca Suna 9Julia Hermes-Laufer 10Corinna B. Brunckhorst 11Firat Duru 12Alexander Breitenstein13Ardan M. Saguner14USZDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandRadiation Protection Unit, University Hospital Zurich, Zurich, SwitzerlandRadiation Protection Unit, University Hospital Zurich, Zurich, SwitzerlandDepartment of Radiation Oncology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, Switzerland/Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Zurich, Switzerland/Center for Integrative Human Physiology, University of Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Zurich, Switzerland/Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland AIM: To establish local diagnostic reference levels for cardiac implantable electronic device procedures and to compare local practice with national guidelines. METHODS: A retrospective cohort study including all consecutive patients from October 2018 to October 2020 who underwent implantation of a cardiac implantable electronic device including pacemaker, implantable cardioverter defibrillator (ICD), cardiac resynchronisation therapy (CRT) or lead extraction / device explantation. Data was collected from a dose management system and cross-checked for accuracy with the patient information system. The pre-specified outcome was patient radiation exposure, evaluated with the kerma area product (KAP), cumulative dose, fluoroscopy time and number of cine acquisitions. The median values were set as local diagnostic reference levels. RESULTS: A total of 541 patients were included. 28.3% had a conventional pacemaker, 22.0% a leadless pacemaker, 21.1% an ICD and 17.2% a CRT implanted, while lead extraction / device explantation was performed in 11.5% of patients. The local diagnostic reference levels for the kerma area product were lower than the national Swiss diagnostic reference levels (0.4 Gray [Gy]∙cm2 vs 30 Gy∙cm2 for conventional pacemakers; 0.4 Gy∙cm2 vs 20 Gy∙cm2 for ICDs; 10.2 Gy∙cm2 vs 57 Gy cm2 for CRTs). Similarly, the local diagnostic reference levels for cumulative dose and fluoroscopy time were below national diagnostic reference levels. CONCLUSIONS: Local diagnostic reference levels values were far below national diagnostic reference levels. A multicentre approach to assess patient radiation exposure in current practice is strongly desired to establish revised national diagnostic reference levels. https://smw.ch/index.php/smw/article/view/4053 |
| spellingShingle | Eleni Theano Samara Lorraine Sazgary Anja Stüssi Natalia Saltybaeva Matthias Guckenberger Frank Ruschitzka Thomas Wolber Nadine Molitor Daniel Hofer Fu Guan Gonca Suna Julia Hermes-Laufer Corinna B. Brunckhorst Firat Duru Alexander Breitenstein Ardan M. Saguner Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre Swiss Medical Weekly |
| title | Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre |
| title_full | Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre |
| title_fullStr | Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre |
| title_full_unstemmed | Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre |
| title_short | Local diagnostic reference levels for cardiac implantable electronic device procedures: data from a tertiary care centre |
| title_sort | local diagnostic reference levels for cardiac implantable electronic device procedures data from a tertiary care centre |
| url | https://smw.ch/index.php/smw/article/view/4053 |
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