Effect of fluoroscopy frame rate on radiation exposure and in‐hospital outcomes in three‐dimensional electroanatomic mapping guided procedures

Abstract

Abstract Background Fluoroscopic imaging involves exposure of the patients and the laboratory staff to ionizing radiation. One of the strategies that reduce such exposure in an electrophysiology laboratory is using a three‐dimensional electroanatomic mapping (3D EAM) system for performing these procedures. In this analysis, we have analyzed the effect of fluoroscopy frame rate on the radiation exposure and in‐hospital outcomes in ablation procedures performed under 3D EAM guidance. Methods We retrospectively analyzed all the ablation procedures performed under 3D EAM guidance at our institute from September 2015 to December 2018. The procedures were divided into two groups based on whether the procedures were performed before (pre) or after (post) January 26, 2018. After January 2018, fluoroscopy was used at a frame rate of 3.75 frames per second (fps). Radiation exposure indices and in‐hospital outcomes were compared between the two groups. Results Ablation procedures included in the analysis were ventricular arrhythmias (n = 192), atrial flutter (115), atrial tachycardia (AT) (43), and atrial fibrillation (AF) (30). Over the study period, there was a significant reduction in procedure time, fluoroscopy time, dose area product, and effective dose (ED) (P < .001). Except for AT and AF ablation procedures, there was a significant reduction in the radiation exposure indices when the “post” group was compared with the “pre” group (P ≤ .02). The decrease in the frame rate had no significant effect on in‐hospital outcomes. Conclusion The use of 3D EAM combined with decreasing the fluoroscopy frame rate significantly reduced the total radiation exposure without adversely affecting in‐hospital outcomes.

Keywords

• atrial flutter
• effective dose
• radiation exposure
• three‐dimensional electroanatomic mapping
• ventricular tachycardia