Casella Michela, Ribatti Valentina, Catto Valentina, Vettor Giulia, Fassini Gaetano, Biagioli Viviana, Dello Russo Antonio, Tondo Claudio
Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino IRCCS, Milan, Italy -
Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino IRCCS, Milan, Italy.
Minerva Cardioangiol. 2018 Feb;66(1):49-62. doi: 10.23736/S0026-4725.17.04478-4. Epub 2017 Aug 31.
Electrophysiology procedures are traditionally performed under fluoroscopic guidance. Nowadays a growing interest in the radiation risk associated to these procedures has been cultivated, since radiation exposure has non-negligible stochastic and deterministic effects on health. A correlation between radiation exposure and lifetime malignancy effect is difficult to establish and the threshold of a completely safe exposure dose is unknown. Thus, electrophisiologists have become aware of the use of fluoroscopy and they have tried to use all the complementary imaging technologies available in order to reduce the radiological exposure. This review is aimed at evaluating the radiation exposure risk, both for the patients and the operators. We describe electroanatomical mapping systems and technologies, which allow the reduction of radiation exposure. We review the main literature based on different catheter ablation procedures with the use of the abovementioned technologies, specifically focusing on feasibility, safety, and radiation exposure. Finally, we highlight the necessity of increasing the radiological risk awareness among operators and cardiological scientific societies.
传统上，电生理手术是在荧光透视引导下进行的。如今，人们越来越关注这些手术所带来的辐射风险，因为辐射暴露对健康具有不可忽视的随机和确定性影响。辐射暴露与终生致癌效应之间的关联难以确立，完全安全的暴露剂量阈值也尚不明确。因此，电生理学家已意识到荧光透视的使用问题，并尝试运用所有可用的辅助成像技术，以减少辐射暴露。本综述旨在评估患者和操作人员面临的辐射暴露风险。我们描述了可减少辐射暴露的电解剖标测系统和技术。我们回顾了基于使用上述技术的不同导管消融手术的主要文献，特别关注其可行性、安全性和辐射暴露情况。最后，我们强调提高操作人员和心脏病学科学学会对辐射风险认识的必要性。
