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采用讲座形式提高意识,降低房颤消融术中的辐射暴露。

Reducing radiation exposure during atrial fibrillation ablation using lectures to promote awareness.

机构信息

Cardiology, Kyorin University Hospital, Tokyo, Japan.

Cardiac Morphology Unit, Department of Paediatrics, Royal Brompton Hospital, London, UK.

出版信息

Open Heart. 2019 Jun 24;6(1):e000982. doi: 10.1136/openhrt-2018-000982. eCollection 2019.

Abstract

OBJECTIVE

Recently, concern has increased regarding the hazards of radiation exposure in patients and laboratory staff. Since the numbers of complex catheter ablations (CA) performed, duration of procedure times, and need for multiple sessions have increased, radiation exposure during each session needs to be minimised. Our study aimed to assess the impact of awareness on radiation exposure during CA for atrial fibrillation (AF).

METHODS

Mini-course lectures was delivered to the physicians and staff in the electrophysiology division. Its effect on the fluoroscopic time and radiation dose during AF ablation before (Group I, n=70), shortly after (Group II: n=70) and remotely after the mini-lecture (Group III, n=70) were evaluated. Patient demographics, preoperative testing and procedural parameters were collected.

RESULTS

The fluoroscopic time significantly reduced after the lecture (Group I and II: 25.1±10.0 and 15.1±7.3 min, respectively (p<0.0001)), and remained so in Group III (13.0±5.4 min), despite the increase in the number of persistent AFs. The radiation dose also significantly reduced (Groups I, II, III: 295.0±263.0, 109.6±103.5 and 110.1±89.6 mGy, respectively (p<0.0001)).

CONCLUSION

Awareness on radiation exposure led to a significant reduction in fluoroscopic time and radiation dose during CA for AF, the effect of which persisted even to remote periods following the procedure.

摘要

目的

最近,人们越来越关注患者和实验室工作人员在辐射暴露方面的危害。由于进行的复杂导管消融 (CA) 的数量、手术时间的持续时间以及需要多次治疗的需求增加,因此需要将每次治疗过程中的辐射暴露降至最低。我们的研究旨在评估对房颤 (AF) 导管消融过程中辐射暴露的认识的影响。

方法

向电生理学部门的医生和工作人员进行了小型课程讲座。评估了在讲座之前(第 I 组,n=70)、之后不久(第 II 组:n=70)和之后远程(第 III 组,n=70)进行 AF 消融时,其对透视时间和辐射剂量的影响。收集了患者的人口统计学资料、术前检查和手术参数。

结果

讲座后透视时间明显减少(第 I 组和第 II 组分别为 25.1±10.0 和 15.1±7.3 分钟(p<0.0001)),在第 III 组中仍保持如此(13.0±5.4 分钟),尽管持续性房颤的数量增加。辐射剂量也显著降低(第 I、II、III 组分别为 295.0±263.0、109.6±103.5 和 110.1±89.6 mGy(p<0.0001))。

结论

对辐射暴露的认识导致 AF 导管消融过程中的透视时间和辐射剂量显著降低,即使在手术结束后的远程时期,这种效果仍然存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5061/6593197/c05e2c1d50fc/openhrt-2018-000982f01.jpg

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