Patient radiation dosimetry during interventional cardiac procedures

Cardiac catheterization plays an essential role in the evaluation of suspected heart failure patients. This work aimed to determine the mean effective dose of patients undergoing catheterization tests and to estimate the associated radiation risk of malignancy.

Measurements were performed during 65 coronary angiographies (CA), 70 coronary angioplasties (PTCA) 27, radio fluoroscopy (RF) ablations and 25 electro physiologies procedures in a dedicated laboratory. The procedures were undertaken with the Siemens and General Electric X-ray equipment. A dose area product (DAP) meter was also used. The DAP values and fluoroscopy times were recorded for each patient.

The mean DAP values and patient effective doses were 19.53 Gy.cm2 and 1.71 mSv for CA, 49.74 Gy.cm2 and 4.57 mSv for PTCA, 153.34 Gy.cm2 and 16.38 mSv for ablations and 14.88 Gy.cm2 and 1.65 mSv for electrophysiology, respectively. The patient radiation risk was estimated at 13, 1.3, 1.3, 3.6 fatal cancer per 10000 procedures of ablations, electrophysiology, CA and PTCA cases, respectively.

Results showed that the radiation risk due to RF cardiac ablation is higher than the other complication procedures so, efforts should be made to minimize patient radiation risk from RF ablation procedures. Also we found no clear correlation between cardiologist level of experience and reduced level of patient’s dose.