Department of Medical Physics, University Hospital Maggiore della Carità, Novara, Italy.
Europace. 2010 Dec;12(12):1769-73. doi: 10.1093/europace/euq356. Epub 2010 Oct 6.
To quantify the reduction in equivalent dose at operator's hand that can be achieved by placement of a radiation-absorbing drape (RADPAD) during long-lasting cardiac resynchronization therapy (CRT) procedures.
This is a prospective observational study that included 22 consecutive patients with drug-refractory heart failure who underwent implantation of a CRT device. The cases were randomly assigned to Group A (11 cases), performed without RADPAD, and to Group B (11 cases), performed using RADPAD. Dose equivalent at the examiner's hand was measured as H(p)(0.07) and as a time-adjusted H(p)(0.07) rate (mGy/min) with a direct reading dosimeter. The mean fluoroscopy time was 20.8 ± 7.7 min and the mean dose area product (DAP) was 118.6 ± 45.3 Gy cm(2). No significant differences were found between body mass index, fluoroscopy time, and DAP between patients examined with or without RADPAD. The correlation between the fluoroscopy time and the DAP was high (R(2) = 0.94, P < 0.001). Mean dose and dose rate measurement without the RADPAD at the finger and hand were H(p)(0.07) = 1.27 ± 0.47 mGy per procedure and H(p)(0.07) rate = 0.057 ± 0.011 mGy/min, respectively. The dosage was reduced with the RADPAD to H(p)(0.07) = 0.48 ± 0.20 (P < 0.05) and to H(p)(0.07) rate = 0.026 ± 0.008 (P < 0.001), respectively.
A mean reduction of 54% in the equivalent dose rate to the operator's hand can be achieved with the use of RADPAD. The use of the RADPAD in CRT devices implantation will make unlikely the necessity of limiting the yearly number of implants for high volume operators.
定量评估在长时间心脏再同步治疗（CRT）过程中使用辐射吸收敷布（RADPAD）可使操作人员手部的等效剂量减少多少。
这是一项前瞻性观察研究，纳入 22 例接受 CRT 装置植入的药物难治性心力衰竭连续患者。将这些病例随机分为 A 组（11 例），未使用 RADPAD；B 组（11 例），使用 RADPAD。使用直接读数剂量计测量操作者手部的等效剂量，分别为 H(p)(0.07)和时间调整的 H(p)(0.07)率（mGy/min）。平均透视时间为 20.8 ± 7.7 分钟，平均剂量面积产物（DAP）为 118.6 ± 45.3 Gy cm(2)。使用或不使用 RADPAD 检查的患者之间，体重指数、透视时间和 DAP 无显著差异。透视时间与 DAP 之间存在高度相关性（R(2) = 0.94，P < 0.001）。未使用 RADPAD 时，手指和手部的平均剂量和剂量率测量值分别为 H(p)(0.07) = 1.27 ± 0.47 mGy/次和 H(p)(0.07)率 = 0.057 ± 0.011 mGy/min。使用 RADPAD 后，剂量分别减少至 H(p)(0.07) = 0.48 ± 0.20（P < 0.05）和 H(p)(0.07)率 = 0.026 ± 0.008（P < 0.001）。
使用 RADPAD 可使操作人员手部的等效剂量率平均降低 54%。在 CRT 装置植入中使用 RADPAD 将使高容量操作人员每年植入的限制必要性降低。
