A contribution to the establishment of diagnostic reference levels in intervention electrophysiology: study from a center in Portugal

• Autor(a) principal: Videira, Sara
• Data de Publicação: 2021
• Outros Autores: Pereira, José Manuel
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.46885/roentgen.v2i2.53
• topic: Interventional electrophysiology; DRLs; Radiological protection; Eletrofisiologia de intervenção; NRD; Proteção radiológica

Most interventional electrophysiology procedures require fluoroscopy therefore exposing all intervening parties to ionizing radiation. The use of diagnostic reference levels (DRLs) can be a useful tool to promote dose optimization. The main objective of this study was to investigate the exposure doses, determining the DRLs.An institutional study, cross-sectional and retrospective was carried out, through the review of electrophysiological diagnostic and/or treatment study procedures and the implantation of cardiac devices, performed between May 23, 2018 and February 19, 2020. The procedures were distributed in groups according to their complexity and determined their diagnostic reference levels for the dose descriptors Cumulative air kerma (CK, mGy) and Air kerma area product (PKA, mGy.cm2). This study included 516 procedures. The determined DRLs were: electrophysiological diagnostic study (12mGy and 3,5Gy.cm2); electrophysiological study with ablation in right heart cavities (62mGy and 20Gy.cm2); electrophysiological study with ablation in left heart cavities (87,5mGy and 32Gy.cm2); atrial fibrillation ablation (103mGy and 34Gy.cm2); implantation of a cardioverter-defibrillator or pacemaker with a passive fixation lead (7mGy and 2,5Gy.cm2) or active (10mGy and 3Gy.cm2) and with two passive fixation leads (9mGy and 3Gy.cm2), or active (15mGy and 4,5Gy.cm2), or an active and one passive (12mGy and 4Gy.cm2); implantation of a cardiac resynchronization device (158,5mGy and 38Gy.cm2) or upgrade (98mGy and 36Gy.cm2). The most complex procedures were those with the highest DRLs.It was determined that most of the DRLs found are below the values published in the literature.