Study On The Dose Of Lens Radiation In Electrophysiological Examination

Research Background:In recent years,with the increasing number of patients with arrhythmia,their diagnosis and treatment technology has also developed rapidly.Electrophysiological studies(EPS)and radio-frequency catheter ablation(RFCA)have become routine methods for clinical diagnosis and treatment of arrhythmias.Both EPS and RFCA require the use of Coronary Sinus(CS)electrodes.At present,most of the electrophysiological catheter rooms choose internal jugular vein access(IJVA)or femoral vein access(FVA).There are advantages and disadvantages to each of the two approaches.At present,the awareness of radiation protection of medical staff in China is still weak,and the harm of radiation is not taken seriously,and the protection of themselves and patients is neglected.Therefore,we need to strengthen the training of relevant personnel to minimize the radiation damage of medical staff and patients.Ionizing radiation is widely used in our lives,but while giving us benefits,excessive exposure can also cause harm to our bodies.Therefore,rapid and accurate dose estimation is particularly important.Objective:To compare the radiation dose of lens by placing the CS mapping electrode through femoral vein and internal jugular vein puncture,Choose a lower dose of radiation to place the coronary sinus electrode.And studying the factors related to lens radiation damage.The current hazards and protective measures of doctors and patients during surgery are analyzed,so as to reduce radiation as much as possible,and even achieve zero exposure,the so-called "green electrophysiology." Methods:From July 1,2018 to March 31,2019,102 patients with arrhythmias underwent electrophysiological examination and / or radiofrequency ablation in the Cardiology catheter room of the first hospital of Shanxi Medical University.Patients were randomly selected internal jugular vein and femoral vein,puncture and placing CS electrode,Coronary sinus electrode placement process is performed by the same surgeon.The two groups were recorded the success rate of venipuncture,the incidence of complications,the time of exposure of the coronary sinus electrode,the exposure dose,and the cumulative dose of lens.Statistical methods were used to compare the.Then analyze puncture success rate,the incidence of complications,x-ray exposure time,exposure dose,and cumulative dose of lens radiation between the two puncture routes the use of statistical methods.Results:In the internal jugular vein group,42 cases(1 case was changed to the femoral vein puncture,becase of repeated punctureing the internal carotid artery,and 1 case was changed to the internal jugular vein because of unsuccessful femoral vein puncture,42-1+1=42)were successfully puncture(puncture success rate 97.6%).Coronary sinus electrodes were successfully implanted in 42 patients with sheath canal implantation(success rate 100%).In the femoral vein group,60 cases(1 case was changed to internal jugular vein puncture due to repeated punctureing of the femoral artery,and 1 case was changed to femoral vein puncture because of insufficient internal carotid vein puncture,60-1+1=60)were punctured successfully(puncture success rate 98.3%).Coronary sinus electrodes were successfully implanted in 60 patients with sheath canal implantation(success rate 100%).There was no significant difference in the success rate of puncture,the incidence of complications and the success rate of placement of coronary sinus electrodes(P>0.05).The exposure time(107.0±20.5s vs 110.6±18.3s),exposure dose(51.9±14.9uGy vs 53.0±13.2uGy)and the cumulative dose of lens radiation(19.9±5.3uGy vs 20.5 ± 6.1uGy)were not significant difference.The radiation dose of lens in the femoral vein group was significantly lower than that in the internal jugular meridian group(7.0±1.7uGy vs 2.3±1.0uGy,P < 0.05).Conclusion:According to the results of the study,the placement of coronary sinus electrodes through the femoral vein and internal jugular vein has a higher success rate and lower incidence of complications.The femoral vein approach has a significantly reduced lens radiation dose,so it is recommended to perform electrophysiological examination and / or radiofrequency ablation.