Evaluation of a radiation protection cabin for invasive electrophysiological procedures

Abstract

Aims: Complex invasive electrophysiological procedures may result in high cumulative operator radiation exposure. Classical protection with lead aprons results in discomfort while radioprotection is still incomplete. This study evaluated the usefulness of a radiation protection cabin (RPC) that completely surrounds the operator. Methods and results: The evaluation was performed independently in two electrophysiology laboratories (E1 - Leuven, Belgium; E2 - Bordeaux, France), comparing operator radiation exposure using the RPC vs. a 0.5 mm lead-equivalent apron (total of 135 procedures). E1 used thermoluminiscent dosimeters (TLDs) placed at 16 positions in and out of the RPC and nine positions in and out of the apron. E2 used more sensitive electronic personal dosimeters (EPD), placed at waist and neck. The sensitivity thresholds of the TLDs and EPDs were 10-20 μSv and 1-1.5 μSv, respectively. All procedures could be performed unimpeded with the RPC. Median TLD dose values outside protected areas were in the range of 57-452 μSv, whereas doses under the apron or inside the RPC were all at the background radiation level, irrespective of procedure and fluoroscopy duration and of radiation energy delivered. In addition, the RPC was protecting the entire body (except the hands), whereas lead apron protection is incomplete. Also with the more sensitive EPDs, the radiation dose within the RPC was at the sensitivity threshold/background level (1.3 ± 0.6 μSv). Again, radiation to the head was significantly lower within the RPC (1.9 ± 1.2 μSv) than with the apron (102 ± 23 μSv, P < 0.001). Conclusion: The use of the RPC allows performing catheter ablation procedures without compromising catheter manipulation, and with negligible radiation exposure for the operator. © The European Society of Cardiology 2006. All rights reserved.