To evaluate operator and patient irradiation during radiofrequency ablation (RFA) of common atrial flutter (AF) using three different fluoroscopy settings.

A total of 38 patients who underwent RFA of AF with three different fluoroscopy settings (low dose, standard dose and collimated field) were included. Twelve patients (11 men, 1 woman; mean age, 67±12 [SD]years) were included in the low dose group (3.75 frames per second), 13 patients (13 men; mean age, 66±8 [SD]years) were included in the standard dose group (7.5 frames per second) and 13 patients (13 men; mean age, 71±12 [SD]years) were included in the collimated field group (7.5 frames per second). Operator and patient exposure were compared between groups.

No differences in procedure time and radiation exposure were found between the three groups. In the low dose group, mean operator X-ray exposures of eye-lens (4.7±2.9 [SD]μSv/h; range: 0.9–10.5μSv/h), whole body (1.6±1.2 [SD]μSv/h; range 0.5–3.6μSv/h) and hand skin (11.1±10.8 [SD] μSv/h; range 2.4–35.4μSv/h) were significantly lower than those in the standard dose group (P<0.001). Significant patient dose reduction was found between low dose group (0.7±0.4 [SD]Gy/h; range: 0.3–0.9Gy/h) and standard (1.7±0.5 [SD]Gy/h; range: 0.8 to 3.9Gy/h) and collimated (1.8±0.5 [SD]Gy/h; range: 0.7–3.0Gy/h) groups (P<0.01).

The use of a low dose setting (3.75 f/s) during fluoroscopy dramatically reduces operator's irradiation during RFA of AF by a mean of 90%.