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Safety timeout reduces radiation in electrophysiology procedures
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CHICAGO — Implementation of a safety timeout significantly reduced radiation exposure during electrophysiology procedures, according to findings presented at the Heart Rhythm Society Annual Scientific Sessions.
“The electrophysiology community has appropriately taken note of the radiation exposure that patients and staff experience during procedures,” Anthony Aizer, MD, MSc, assistant professor of medicine at NYU Langone Medical Center, told Cardiology Today. “While novel technologies have resulted in reductions in radiation exposure, all of these technologies are not universally available and their use has attendant risks and benefits.”
Baseline data were collected for 6 months on 592 adult electrophysiology procedures. After implementation of the radiation safety timeout procedure, data were collected prospectively every 3 months for up to 12 months (n = 448 cases).
Aizer and colleagues assessed for mean dose area product, reference dose, fluoroscopy time, use of additional shielding and use of alternative imaging.
The study was halted after three months.
After the timeout procedure was implemented, mean dose area product was reduced by 22% from 36.5 Gy*cm2 (P = .013) and mean reference dose decreased by 26% from 342 mGy (P = .007).
Ultrasound imaging for venous access decreased after the timeout procedure was implemented (P < .001) and use of additional radiation shields increased (53.4% before timeout, 61.6% during timeout; P = .009). All associations remained significant after adjustment for BMI, proceduralist and procedure type.
The timeout had no effect on procedure time or complications, Aizer and colleagues found.
The researchers wrote in an abstract that electrophysiology laboratories and other facilities that use fluoroscopy should consider implementing radiation safety timeouts.
“Rather than using new equipment, a radiation safety timeout focused operators to best use equipment already available in procedure rooms,” Aizer told Cardiology Today. “As such, use of a radiation safety timeout may be a novel, inexpensive means to reduce radiation exposure in many electrophysiology laboratories. However, it is important to note, that this analysis was performed at [a single center]. Further data to assess the utility of a radiation safety timeout in other medical centers is needed to better understand the extent to which a radiation safety timeout may be of benefit in other clinical environments.” – by Cassie Homer
Reference:
Aizer A, et al. Abstract C-PO01-91. Presented at: Heart Rhythm Society Annual Scientific Sessions; May 10-13, 2017; Chicago.
Disclosure: Aizer reports consulting for Biosense Webster.