Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation

Abstract Background and Aims Optimization of fluoroscopic image quality for reducing radiation exposure in cryoballoon pulmonary vein isolation (CB‐PVI) has not yet been fully investigated. Therefore, we tried to compare the radiation doses among three different X‐ray system settings. Methods Consec...

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Main Authors: Takashi Kaneshiro, Sadahiro Murota, Takeshi Nehashi, Minoru Nodera, Shinya Yamada, Masamitsu Ikeda, Yasuchika Takeishi
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Journal of Arrhythmia
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Online Access:https://doi.org/10.1002/joa3.13179
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author Takashi Kaneshiro
Sadahiro Murota
Takeshi Nehashi
Minoru Nodera
Shinya Yamada
Masamitsu Ikeda
Yasuchika Takeishi
author_facet Takashi Kaneshiro
Sadahiro Murota
Takeshi Nehashi
Minoru Nodera
Shinya Yamada
Masamitsu Ikeda
Yasuchika Takeishi
author_sort Takashi Kaneshiro
collection DOAJ
description Abstract Background and Aims Optimization of fluoroscopic image quality for reducing radiation exposure in cryoballoon pulmonary vein isolation (CB‐PVI) has not yet been fully investigated. Therefore, we tried to compare the radiation doses among three different X‐ray system settings. Methods Consecutive 148 patients scheduled for their first CB‐PVI were prospectively enrolled: low dose with the use of an anti‐scatter grid for the first 51 patients (LD + G group), low dose without an anti‐scatter grid for the subsequent 46 patients (LD‐G group), and ultralow dose (ULD group) with an anti‐scatter grid for the remaining 51 patients. We compared the radiation doses required to complete CB‐PVI procedures among the groups. There were 27 patients for whom CB‐PVI was performed without cine acquisition, but with fluoroscopy only, and the radiation doses were also compared. Results The median procedure time and fluoroscopy time were 119 and 35.5 min, respectively, with no significant differences among the groups. The median cumulative air Kerma (AK) decreased in both the LD‐G group (71.8 mGy, p < .001) and the ULD group (73.0 mGy, p < .001), compared to the LD + G group (145.0 mGy). Among 27 patients who underwent CB‐PVI without cine acquisition, the median cumulative AK further decreased in both the LD‐G group (31.4 mGy, p < .05) and the ULD group (22.7 mGy, p < .01), compared to the LD + G group (64.6 mGy). Conclusion Using an ULD X‐ray setting and avoiding cine acquisition, we can reduce radiation exposure, while ensuring the necessary fluoroscopy time for the CB‐PVI procedure.
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spelling doaj-art-d2ff7a7314134809986de79f89271e8d2025-08-20T02:33:43ZengWileyJournal of Arrhythmia1880-42761883-21482024-12-014061400140710.1002/joa3.13179Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablationTakashi Kaneshiro0Sadahiro Murota1Takeshi Nehashi2Minoru Nodera3Shinya Yamada4Masamitsu Ikeda5Yasuchika Takeishi6Department of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Radiology Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanAbstract Background and Aims Optimization of fluoroscopic image quality for reducing radiation exposure in cryoballoon pulmonary vein isolation (CB‐PVI) has not yet been fully investigated. Therefore, we tried to compare the radiation doses among three different X‐ray system settings. Methods Consecutive 148 patients scheduled for their first CB‐PVI were prospectively enrolled: low dose with the use of an anti‐scatter grid for the first 51 patients (LD + G group), low dose without an anti‐scatter grid for the subsequent 46 patients (LD‐G group), and ultralow dose (ULD group) with an anti‐scatter grid for the remaining 51 patients. We compared the radiation doses required to complete CB‐PVI procedures among the groups. There were 27 patients for whom CB‐PVI was performed without cine acquisition, but with fluoroscopy only, and the radiation doses were also compared. Results The median procedure time and fluoroscopy time were 119 and 35.5 min, respectively, with no significant differences among the groups. The median cumulative air Kerma (AK) decreased in both the LD‐G group (71.8 mGy, p < .001) and the ULD group (73.0 mGy, p < .001), compared to the LD + G group (145.0 mGy). Among 27 patients who underwent CB‐PVI without cine acquisition, the median cumulative AK further decreased in both the LD‐G group (31.4 mGy, p < .05) and the ULD group (22.7 mGy, p < .01), compared to the LD + G group (64.6 mGy). Conclusion Using an ULD X‐ray setting and avoiding cine acquisition, we can reduce radiation exposure, while ensuring the necessary fluoroscopy time for the CB‐PVI procedure.https://doi.org/10.1002/joa3.13179atrial fibrillationcryoballoon pulmonary vein isolationradiation exposureultralow‐dose setting
spellingShingle Takashi Kaneshiro
Sadahiro Murota
Takeshi Nehashi
Minoru Nodera
Shinya Yamada
Masamitsu Ikeda
Yasuchika Takeishi
Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation
Journal of Arrhythmia
atrial fibrillation
cryoballoon pulmonary vein isolation
radiation exposure
ultralow‐dose setting
title Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation
title_full Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation
title_fullStr Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation
title_full_unstemmed Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation
title_short Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow‐dose settings in cryoballoon ablation
title_sort achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow dose settings in cryoballoon ablation
topic atrial fibrillation
cryoballoon pulmonary vein isolation
radiation exposure
ultralow‐dose setting
url https://doi.org/10.1002/joa3.13179
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