Impact of dose reducing software on patient and staff temple dose during fluoroscopically guided pacemaker insertion, closure devices implantation and coronary angiography procedures

• Published in: Australasian physical & engineering sciences in medicine Vol. 45; no. 2; pp. 589 - 599
• Main Authors: Wilson-Stewart, Kelly S., Fontanarosa, Davide, Malacova, Eva, Trapp, Jamie V.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2022; Springer Nature B.V
• Subjects: Angiography; Biological and Medical Physics; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Biophysics; Implantation; Insertion; Medical and Radiation Physics; Medical imaging; Nurses; Occlusion; Pacemakers; Radiation; Radiation dosage; Radiation effects; Scientific Paper; Software; Cardiac closure devices; Occupational exposure; Noise reduction; Nursing dose
• ISSN: 2662-4729; 0158-9938; 2662-4737; 1879-5447
• DOI: 10.1007/s13246-022-01126-2

The aim of this study is to investigate the effectiveness of dose reducing software (ClarityIQ) on patient and staff dose during fluoroscopically guided cardiac procedures. Dose measurements were collected in a room without dose reducing software (n = 157) and compared with similar procedures performed in two rooms with the software (n = 1141). Procedures included diagnostic coronary angiography, percutaneous coronary intervention, deployment of cardiac closure devices (for occlusion of atrial septal defect, patent foramen ovale, and atrial appendage) and insertion of permanent pacemakers. The dose reducing software was found to be effective in reducing patient and staff dose by approximately 50%. This study has added to the limited literature reporting on the capability of dose reducing software to decrease radiation exposure during the implantation of cardiac closure devices, as well as demonstrating a reduction in dose to the cardiologist and nursing staff. Administrators should ensure timely upgrades to angiographic equipment to safeguard patients and staff against the potentially adverse effects of radiation exposure. Regardless of the use of dose reducing software, the mean occupational dose during closure devices was in descending order scout > scrub > cardiologist. Scrub nurse dose was found to be higher than the cardiologist during closure devices (0.98/0.26 μSv) and diagnostic coronary angiograms (1.51/0.82 μSv). Nursing staff should be aware that their levels of radiation dose during some cardiac procedures may come close to or even exceed that of the cardiologist.