Catheter ablations are traditionally performed under fluoroscopic guidance. Besides other peri-interventional risks, radiation exposure should be considered for its stochastic and deterministic effects on health. These effects are cumulative and lifelong and raise great concerns especially in the younger population. A document of the American College of Cardiology recommends that all catheterization laboratories adopt the principles of ‘ALARA’ (radiation doses ‘As Low As Reasonably Achievable’), making radiation reduction an ethical issue. In electrophysiology, thanks to the recent development of electroanatomic navigation systems, we are witnessing the birth of a new era in which almost all arrhythmias may be treated without the use of fluoroscopy. In the present review, we start by describing risks to health due to radiation exposure for conventional transcatheter ablations and we continue by reporting the current state of art of the zero fluoroscopy approach.
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Andreassi M, Piccaluga E, Guagliumi G, et al. Occupational Health Risks in Cardiac Catheterization Laboratory Workers. Circ Cardiovasc Interv. 2016 Apr;9(4):e003273.
The purpose of this study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure.