2019 Volume 39 Issue 1 Pages 25-32
Background : Since fluoroscopy time for atrial fibrillation（AF）catheter ablation procedure is usually longer than for other tachyarrhythmia, greater attention should be paid to the occurrence of tissue reactions such as skin injury. Recently, in addition to radiofrequency ablation（RFA）, cryoballoon ablation （CBA） and hotballoon ablation （HBA） have been performed. The aim of this study was to evaluate the difference in entrance skin dose（ESD）due to the procedure in patients who received AF ablation. Methods : The study population consists of 342 consecutive patients（233 male and 109 female）who received ablation for AF at Nagoya Daini Red Cross Hospital from May 2017 to February 2018. Collected data included gender, age, fluoroscopy time, the number of cine frames, reference air-kerma（RAK）, dose area product and type of AF. ESD was evaluated by use of RAK displayed on angiography system. Results : Mean fluoroscopy time, mean number of cine frames, and mean ESD during AF ablation were 53.1minutes, 388frames and 303.3mGy, respectively. The approach for pulmonary vein isolation （PVI） which required the longest fluoroscopic time was RFA（60.1minutes）, followed by HBA（52.5minutes）, CBA（48.2minutes）. On the other hand, the approach for PVI which showed the highest ESD was HBA（427.4mGy）, followed by CBA（306.8mGy）, and RFA（281.7mGy）. Despite the fact that the longest fluoroscopy times in the left anterior oblique projection were up to 79.4minutes, the evaluated ESD values were under the threshold of 2Gy for acute skin injury. Conclusions : Previously, PVI for AF ablation sometimes caused radiation skin injury, but as a result of recent advances in various dose reduction technologies, radiation exposure has been greatly reduced.
