ORIGINAL PAPER
Radiographic implications of procedures involving cardiac implantable electronic devices (CIEDs) – Selected aspects
More details
Hide details
1
Warszawski Uniwersytet Medyczny / Medical University of Warsaw, Warszawa, Poland
(I Katedra i Klinika Kardiologii / 1st Department of Cardiology)
2
Instytut Medycyny Doświadczalnej i Klinicznej im. M. Mossakowskiego PAN, Warszawa, Polska / Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
3
Samodzielny Publiczny Centralny Szpital Kliniczny / Central University Hospital, Warszawa, Poland
(Klinika Kardiologii / Department of Cardiology)
4
Centralny Szpital Kliniczny Ministerstwa Spraw Wewnętrznych i Administracji w Warszawie / Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warszawa, Poland
5
Towarzystwo Ubezpieczeń na Życie BNP Paribas Cardif Polska S.A. / Cardif Assurances Risques Divers Poland S.A., Warszawa, Poland
Online publication date: 2017-04-24
Corresponding author
Dariusz Artur Kosior
Centralny Szpital Kliniczny
Ministerstwa Spraw Wewnętrznych i Administracji, Klinika Kardiologii i Nadciśnienia Tętniczego,
ul. Wołoska 137, 02-507 Warszawa
Med Pr Work Health Saf. 2017;68(3):363-74
KEYWORDS
TOPICS
ABSTRACT
Background: Some cardiac implantable electronic device (CIED) implantation procedures require the use of X-rays, which is
reflected by such parameters as total fluoroscopy time (TFT) and dose-area product (DAP – defined as the absorbed dose multiplied
by the area irradiated). Material and Methods: This retrospective study evaluated 522 CIED implantation (424 de novo
and 98 device upgrade and new lead placement) procedures in 176 women and 346 men (mean age 75±11 years) over the period
2012–2015. The recorded procedure-related parameters TFT and DAP were evaluated in the subgroups specified below. The
group of 424 de novo procedures included 203 pacemaker (PM) and 171 implantable cardioverter-defibrillator (ICD) implantation
procedures, separately stratified by single-chamber and dual-chamber systems. Another subgroup of de novo procedures
involved 50 cardiac resynchronization therapy (CRT) devices. The evaluated parameters in the group of 98 upgrade procedures
were compared between 2 subgroups: CRT only and combined PM and ICD implantation procedures. Results: We observed differences
in TFT and DAP values between procedure types, with PM-related procedures showing the lowest, ICD – intermediate (with values for single-chamber considerably lower than those for dual-chamber systems) and CRT implantation procedures –
highest X-ray exposure. Upgrades to CRT were associated with 4 times higher TFT and DAP values in comparison to those during
other upgrade procedures. Cardiac resynchronization therapy de novo implantation procedures and upgrades to CRT showed
similar mean values of these evaluated parameters. Conclusions: Total fluoroscopy time and DAP values correlated progressively
with CIED implantation procedure complexity, with CRT-related procedures showing the highest values of both parameters.
Med Pr 2017;68(3):363–374