Patient Exposure during Fluoroscopy-guided Pacemaker Implantation Procedures
M Alkhorayef 1, A Sulieman 2, E Babikir 3, E Daar 4, M Alnaaimi 5, M Alduaij 5, D Bradley 6
Affiliations
Affiliations
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P. O.Box 10219, Riyadh 11433, Saudi Arabia; Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH,UK. Electronic address: malkhorayef@ksu.edu.sa.
- Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O.Box 422, Alkharj 11942, Saudi Arabia.
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, P. O.Box 10219, Riyadh 11433, Saudi Arabia.
- Department of Physics, Faculty of Science, The University of Jordan, Amman 11942, Jordan.
- Department of Nuclear Medicine, Kuwait Cancer Control Centre, Shwiekh, Kuwait.
- Sunway University, Institute for Health Care Development, Jalan Universiti, 46150 PJ, Malaysia.
Abstract
A pacemaker, which is used for heart resynchronization with electrical impulses, is used to manage many clinical conditions. Recently, the frequency of pacemaker implantation procedures has increased to more than 50% worldwide. During this procedure, patients can be exposed to excessive radiation exposure. Wide range of doses has been reported in previous studies, suggesting that optimization of this procedure has not been fulfilled yet. The current study evaluated patient radiation exposure during cardiac pacemaker procedures and quantified the patient effective dose. A total of 145 procedures were performed for five pacemaker procedures (VVI, VVIR, VVD, VVDR, and DDDR) at two hospitals. Patient doses were measured using the kerma-area product meter. Effective doses were estimated using software based on Monte Carlo simulation from the National Radiological Protection Board (NRPB, now The Health Protection Agency). The effective dose values were used to estimate cancer risk from the pacemaker procedure. Patient demographic data and exposure parameters for fluoroscopy and radiography were quantified. The mean patient doses ± SD per procedure (Gycm2) for VVI, VVIR, VVD, VVDR, and DDDR were 1.52 ± 0.13 (1.43-1.61), 3.28 ± 2.34 (0.29-8.73), 3.04 ± 1.67 (1.57-4.86), 6.04 ± 2.326 3.29-8.58), and 8.8 ± 3.6 (4.5-26.20), respectively. The overall patient effective dose was 1.1mSv per procedure. It is obvious that the DDDR procedure exposed patients to the highest radiation dose. Patient dose variation can be attributed to procedure type, exposure parameter settings, and fluoroscopy time. The results of this study showed that patient doses during different pacemaker procedures are lower compared to previous reported values. Patient risk from pacemaker procedure is low, compared to other cardiac interventional procedures. Patients' exposures were mainly influenced by the type of procedures and the clinical indication.
Keywords: Effective dose; Interventional radiology; Medical exposure; Pacemaker; Radiation dosimetry.
References
https://pubmed.ncbi.nlm.nih.gov/