The effectiveness of additional lead-shielding drape and low pulse rate fluoroscopy in protecting staff from scatter radiation during cardiac resynchronization therapy (CRT)
Cardiac resynchronization therapy (CRT) often requires a long fluoroscopic time and protection from scatter radiation. This study reports on scatter radiation levels during CRT, with and without additional shielding, and using standard or low pulse rate fluoroscopy.
Materials and methods
Additional lead-shielding drape (0.35-mm lead equivalent) was used on the left side of the table and pulsed fluoroscopy was performed at rates of 10 pulses/s (usual rate) and 7.5 pulses/s (low pulse rate). Fluoroscopy scatter radiation was measured for both pulse rates using an acrylic phantom with a radiation survey meter, both with and without the additional lead-shielding drape.
With the additional lead-shielding drape, the fluoroscopy scatter radiation was reduced by 74.3% at 10 pulses/s and 78.6% at 7.5 pulses/s. If the fluoroscopy was changed from 10 pulses/s to 7.5 pulses/s, the scattered radiation at the primary physician’s position was reduced by 24.0%. The combined use of additional shielding drape and low pulse rate fluoroscopy reduced scatter radiation by over 80%.
Additional lead-shielding drape and low pulse rate fluoroscopy are effective in reducing the scattered radiation dose to physicians and nurses during CRT.
KeywordsCRT procedure Additional lead-shielding drape Low pulse rate fluoroscopy Radiation protection Scatter radiation
We would like to acknowledge Koichi Tabayashi, MD, PhD Department of Cardiovascular Center, Tohoku Medical and Pharmaceutical University Hospital. We also thank Hiroo Chiba RT, Department of Radiology, Tohoku Medical and Pharmaceutical University Hospital, for technical assistance in this study. We thank Karl Embleton, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 4.Butter C, Schau T, Meyhoefer J, Neumann K, Minden HH, Engelhardt J. Radiation exposure of patient and physician during implantation and upgrade of cardiac resynchronization devices. Pacing Clin Electrophysiol. 2010;33:1003–12.Google Scholar
- 13.Valentin J. Avoidance of radiation injuries from medical interventional procedures. Ann ICRP. 2000;30:7–67.Google Scholar
- 22.ICRP publication 103. The 2007 recommendations of the International Commission on Radiological Protection. Ann ICRP. 2007;37:1–332.Google Scholar