Author + information
- Justin Vandermolena,b,
- Andrew Einsteina,b,
- Igor Shuryaka,b,
- Stephen Baltera,b,
- Johanna Meulepasa,b,
- Ryan Kinga,b,
- Neil Mehtaa,b,
- David Brennera,b and
- Anil Gehia,b
Background: Risks of atrial fibrillation ablation (AFA) include the potential risk for cancer due to ionizing radiation exposure. Our study estimates excess lifetime cancer risk related to radiation exposure during AFA.
Methods: Demographic, clinical, and procedural data were collected in 181 consecutive AFA patients at the University of North Carolina at Chapel Hill between November 2014 and April 2016. Organ-specific radiation doses were estimated using Monte Carlo simulation and cancer risk was estimated using radio-epidemiological models reflecting organ dose, patient age and sex, adjusted with patient-specific life tables based on CHA2DS2-VASc score.
Results: Among 181 patients undergoing AFA (age 63.5+10.1, 71% male, 50% persistent atrial fibrillation), median fluoroscopy time was 27.6 minutes and median kerma-area product was 11.9 Gy×cm2. Fluoroscopy dose was significantly higher with increased body mass index (p<0.001), lower age (p=0.037), and certain operators (p<0.001). Mean estimated cancer risk from a single AFA was 4.6 (± 9.7, range 0.1-89.7) per 100,000 patients, i.e. 1 in 21,700 patients. Lifetime risk varied significantly depending on age at ablation (p<0.001, Figure).
Conclusions: Cancer risk from AFA is relatively low, and less than the 1 in 700 estimated risk of acute procedure-related mortality. Although radiation exposure should always be minimized, particular attention should be paid to younger and overweight patients who are at higher risk from exposure.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Innovative Approaches for Reducing Risk and Improving Outcomes With Ablation
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1237-109
- 2017 American College of Cardiology Foundation