Investigation of Erythema, Radiation Dose, and Radiation-Induced Apoptosis in the Peripheral Blood Lymphocytes of Patients Treated with Radiofrequency Catheter Ablation

The long-term use of fluoroscopy in cardiac interventional procedures increases the patient dose and causes severe skin reactions, which lead to growing concern. The aim of the present study was to evaluate the risk and the effect of X-ray irradiation on apoptosis in the peripheral blood lymphocytes of patients treated with ablation in electrophysiological studies. A total of 30 patients who underwent ablation therapy participated in this study. The absorbed dose in the given area was measured by a thermos luminescent dosimeter (TLD). The duration of dose delivery, absorbed dose by the apparatus, and dose area product (DAP) factor were measured for each patient. The skin changes were observed within the 1st day to 5th week after the operation. Blood sampling was conducted (before and 24 h after the treatment), and then, flow cytometry was performed to investigate the apoptotic changes in the blood lymphocytes. The statistical analysis showed that there was a significant difference in the apoptosis of patient blood lymphocytes before irradiation and following that (p <0.05). There was a correlation between the amount of DAP and TLD dose (p <0.001). Furthermore, a correlation was observed between the total apoptosis and fluoroscopic time. The patient radiation dose in the ablation test was not in the threshold level required to create skin erythema. The results of the present study revealed that the use of long-time fluoroscopy in electrophysiological studies may cause a significant increase of apoptosis in the peripheral blood lymphocyte of patients treated using this procedure.