Impact of Obesity on Overall Radiation Exposure for Patients Who Underwent Radiofrequency Ablation of Atrial Fibrillation

• Published in: The American journal of cardiology 2019-10, Vol.124 (8), p.1213-1217
• Main Authors: Faroux, Laurent, Lesaffre, François, Blanpain, Thierry, Mora, Caroline, Nazeyrollas, Pierre, Metz, Damien
• Format: Article
• Language: English
• Subjects: Ablation; Aged; Atrial Fibrillation - complications; Atrial Fibrillation - diagnosis; Atrial Fibrillation - surgery; Cardiac arrhythmia; Catheter Ablation - methods; Catheters; Computation; Computed tomography; Dose-Response Relationship, Radiation; Dosimetry; Electrocardiography; Exposure; Female; Fibrillation; Fluoroscopy - adverse effects; Follow-Up Studies; France - epidemiology; Humans; Incidence; Ionizing radiation; Male; Middle Aged; Multivariate analysis; Obesity; Obesity - complications; Radiation effects; Radiation Exposure - adverse effects; Radiation Injuries - epidemiology; Radiation Injuries - etiology; Radio frequency; Radiofrequency ablation; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed - adverse effects; Weight
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2019.07.018

Patients who underwent radiofrequency ablation of atrial fibrillation are exposed to X-rays not only during the procedure but also during the preprocedural computed tomography. No study has investigated the cumulative effective dose received by patients who underwent atrial fibrillation ablation and identified factors influencing this dose. We aimed to evaluate the overall exposure to ionizing radiation in patients who underwent radiofrequency ablation of atrial fibrillation. The secondary objective was to estimate the impact of obesity on this exposure. All patients who underwent a first attempt of radiofrequency ablation of atrial fibrillation in our center over a 21 months period were included. Dosimetric indicators from preprocedural computed tomography and the ablation procedure were collected and converted into an effective dose. A total of 144 radiofrequency ablation of atrial fibrillation were included. The mean cumulative effective dose was 11.4 mSv, and 82% of the dose was from the computed tomography. Obese patients received a dose that was 75% higher than normal-weight patients, and this increase remained significant by multivariate analysis. In conclusion, overall exposure to ionizing radiation for patients who underwent radiofrequency ablation of atrial fibrillation seems acceptable, and the majority of the overall effective dose comes from the computed tomography. Obese patients are exposed to a 75% higher dose than normal-weight patients.