University of Zagreb, School of Medicine, Zagreb, Croatia.
Gottsegen National Cardiovascular Center, Hungarian Paediatric Heart Center, Budapest, Hungary.
Pediatr Cardiol. 2024 Apr;45(4):804-813. doi: 10.1007/s00246-024-03428-6. Epub 2024 Feb 27.
The main goal of this study is to determine typical values of dose area product (DAP) and difference in the effective dose (ED) for pediatric electrophysiological procedures on the heart in relation to patient body mass. This paper also shows DAP and ED in relation to the indication, the arrhythmia substrate determined during the procedure, and in relation to the reason for using radiation. Organ doses are described as well. The subjects were children who have had an electrophysiological study done with a 3D mapping system and X-rays in two healthcare institutions. Children with congenital heart defects were excluded. There were 347 children included. Significant difference was noted between mass groups, while heavier children had higher values of DAP and ED. Median DAP in different mass groups was between 4.00 (IQR 1.00-14.00) to 26.33 (IQR 8.77-140.84) cGycm. ED median was between 23.18 (IQR 5.21-67.70) to 60.96 (IQR 20.64-394.04) µSv. The highest DAP and ED in relation to indication were noted for premature ventricular contractions and ventricular tachycardia-27.65 (IQR 12.91-75.0) cGycm and 100.73 (IQR 53.31-258.10) µSv, respectively. In arrhythmia substrate groups, results were similar, and the highest doses were in ventricular substrates with DAP 29.62 (IQR 13.81-76.0) cGycm and ED 103.15 (IQR 60.78-266.99) µSv. Pediatric electrophysiology can be done with very low doses of X-rays when using 3D mapping systems compared to X-rays-based electrophysiology, or when compared to pediatric interventional cardiology or adult electrophysiology.
本研究的主要目的是确定与患者体重相关的儿科心脏电生理程序的剂量面积产品（DAP）和有效剂量（ED）的典型值。本文还展示了与适应证、程序中确定的心律失常基质以及使用辐射的原因相关的 DAP 和 ED。还描述了器官剂量。研究对象为在两家医疗机构接受 3D 映射系统和 X 射线进行电生理研究的儿童。排除了患有先天性心脏病的儿童。共纳入 347 名儿童。在体重组之间观察到显著差异，而较重的儿童的 DAP 和 ED 值更高。不同体重组的 DAP 中位数在 4.00（IQR 1.00-14.00）至 26.33（IQR 8.77-140.84）cGycm 之间。ED 中位数在 23.18（IQR 5.21-67.70）至 60.96（IQR 20.64-394.04）µSv 之间。与适应证相关的最高 DAP 和 ED 值见于室性早搏和室性心动过速-27.65（IQR 12.91-75.0）cGycm 和 100.73（IQR 53.31-258.10）µSv。在心律失常基质组中，结果相似，最高剂量出现在心室基质中，DAP 为 29.62（IQR 13.81-76.0）cGycm，ED 为 103.15（IQR 60.78-266.99）µSv。与基于 X 射线的电生理相比，或与儿科介入心脏病学或成人电生理相比，使用 3D 映射系统进行儿科电生理可以使用非常低剂量的 X 射线。
