Radiation dose reference levels for the most common image-guided interventional cardiac electrophysiology and pacing procedures: a French multicentre survey
Abstract
Purpose: To set national dose interventional reference levels (IRLs) for adults undergoing the most common cardiac electrophysiology and pacing procedures. Materials and methods: A national multicentre survey was performed in 33 French cardiac electrophysiology and pacing departments. Eleven standard image-guided interventional procedures in cardiac electrophysiology and pacing were analysed. Air Kerma (AK), kerma-area product (PKA) and fluoroscopy time (T) were recorded for 10 to 30 patients per procedure and per centre. IRLs were calculated as the 3rd quartiles and medians of distributions. Results: A total of 4219 patients (70.4 ± 14.4 years old, 32% women) were included. IRLs were suggested for three dosimetric indicators in the eleven procedures. For endovascular implantation (pacemaker and defibrillator), IRLs increased with the complexity of procedures. In terms of PKA and T, IRLs were 4.10 Gy.cm2 and 5.5 min for single-chamber pacemakers, 11.50 Gy.cm2 and 16.5 min for bi-ventricular pacemakers, 2.25 Gy.cm2 and 4.0 min for single-chamber defibrillators and 12.90 Gy.cm2 and 18.0 min for bi-ventricular defibrillators. For all pacemaker procedures, left bundle branch area pacing significantly increased PKA, AK, and T values (p < 0.05). For ablations, the lowest IRLs were found for accessory pathway ablation (4.10 Gy.cm2 and 10.5 min) and the highest for ablation of persistent atrial fibrillation (12.65 Gy.cm2 and 15.5 min). For all ablations, the main energy source used was radiofrequency (>75% of procedures). For most procedures, the IRLs proposed were close to most of those already published, or lower. Conclusion: This national multicentre study reports IRLs for the most common image-guided interventional cardiac electrophysiology and pacing procedures.
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BibTeX
@article{greffier2026radiation,
title = {{Radiation dose reference levels for the most common image-guided interventional cardiac electrophysiology and pacing procedures: a French multicentre survey}},
author = {Joël Greffier and Elodie Dhombres and Djamel Dabli and Maxime de Guillebon and Paraskevi Charalampatou and Joëlle Ann Feghali and Elie Ganacheau and Valérie Desroys Du Roure and Cynthia Goutain-Majorel and Brice Royer and Antoine Milhem and Pauline Arsac and Simon David and Mathilde Diot-Vaschy and Guillaume Serzian and Barbara Chatterjee and Pierre Frey and Anne Guenet and Bénédicte Perrin and Anthony Fernandez and Franck Couzon and Antoine Da Costa and Cyril Leleu and Aurore Taylor and Vianney Behaghel and Nathalie Bestion and Julien Le Roy and Laurie Cabrol Faivre and Maïlys Michel and Bruno Degand and Solène Collet and Emmanuel Burguin and Charlotte Pichenot and Stéphane Fromentin and Didier Paul and Barbara Girard-Bertrand and Emilie Varlet and Isabelle Fitton and Rui Guerra and Elise Bottlaender and Anne-Sophie Vazé and Sylvie Monfraix and Antoine Lepillier and Olivier Paziaud and Hervé Desflaches and Hugo Brahic and Chris Serrand and Julie Roux and Guillaume Cayla and Pierre François Winum},
journal = {Physica Medica European Journal of Medical Physics},
year = {2026},
month = oct,
doi = {10.1016/j.ejmp.2026.105898},
url = {https://hal.science/hal-05775283v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Radiation dose reference levels for the most common image-guided interventional cardiac electrophysiology and pacing procedures: a French multicentre survey
AU - Joël Greffier
AU - Elodie Dhombres
AU - Djamel Dabli
AU - Maxime de Guillebon
AU - Paraskevi Charalampatou
AU - Joëlle Ann Feghali
AU - Elie Ganacheau
AU - Valérie Desroys Du Roure
AU - Cynthia Goutain-Majorel
AU - Brice Royer
AU - Antoine Milhem
AU - Pauline Arsac
AU - Simon David
AU - Mathilde Diot-Vaschy
AU - Guillaume Serzian
AU - Barbara Chatterjee
AU - Pierre Frey
AU - Anne Guenet
AU - Bénédicte Perrin
AU - Anthony Fernandez
AU - Franck Couzon
AU - Antoine Da Costa
AU - Cyril Leleu
AU - Aurore Taylor
AU - Vianney Behaghel
AU - Nathalie Bestion
AU - Julien Le Roy
AU - Laurie Cabrol Faivre
AU - Maïlys Michel
AU - Bruno Degand
AU - Solène Collet
AU - Emmanuel Burguin
AU - Charlotte Pichenot
AU - Stéphane Fromentin
AU - Didier Paul
AU - Barbara Girard-Bertrand
AU - Emilie Varlet
AU - Isabelle Fitton
AU - Rui Guerra
AU - Elise Bottlaender
AU - Anne-Sophie Vazé
AU - Sylvie Monfraix
AU - Antoine Lepillier
AU - Olivier Paziaud
AU - Hervé Desflaches
AU - Hugo Brahic
AU - Chris Serrand
AU - Julie Roux
AU - Guillaume Cayla
AU - Pierre François Winum
PY - 2026
DA - 2026/10/02
JO - Physica Medica European Journal of Medical Physics
DO - 10.1016/j.ejmp.2026.105898
UR - https://hal.science/hal-05775283v1
AB - Purpose: To set national dose interventional reference levels (IRLs) for adults undergoing the most common cardiac electrophysiology and pacing procedures. Materials and methods: A national multicentre survey was performed in 33 French cardiac electrophysiology and pacing departments. Eleven standard image-guided interventional procedures in cardiac electrophysiology and pacing were analysed. Air Kerma (AK), kerma-area product (PKA) and fluoroscopy time (T) were recorded for 10 to 30 patients per procedure and per centre. IRLs were calculated as the 3rd quartiles and medians of distributions. Results: A total of 4219 patients (70.4 ± 14.4 years old, 32% women) were included. IRLs were suggested for three dosimetric indicators in the eleven procedures. For endovascular implantation (pacemaker and defibrillator), IRLs increased with the complexity of procedures. In terms of PKA and T, IRLs were 4.10 Gy.cm2 and 5.5 min for single-chamber pacemakers, 11.50 Gy.cm2 and 16.5 min for bi-ventricular pacemakers, 2.25 Gy.cm2 and 4.0 min for single-chamber defibrillators and 12.90 Gy.cm2 and 18.0 min for bi-ventricular defibrillators. For all pacemaker procedures, left bundle branch area pacing significantly increased PKA, AK, and T values (p < 0.05). For ablations, the lowest IRLs were found for accessory pathway ablation (4.10 Gy.cm2 and 10.5 min) and the highest for ablation of persistent atrial fibrillation (12.65 Gy.cm2 and 15.5 min). For all ablations, the main energy source used was radiofrequency (>75% of procedures). For most procedures, the IRLs proposed were close to most of those already published, or lower. Conclusion: This national multicentre study reports IRLs for the most common image-guided interventional cardiac electrophysiology and pacing procedures.
SN - 1120-1797
SN - 1724-191X
ER -