Cardiac Rhythm Management
Articles Articles 2012 December

Letter to the Editor in Chief

DOI: 10.19102/icrm.2012.031202

R. Chris Jones, MD

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Reducing Fluoroscopy Times and Improving Radiation Safety


In my lifetime, I have only kept two New Year's resolutions. In 2004 I vowed to not visit, and in 2012 I decided to emphasize a dramatic drop in our lab's fluoroscopy times with atrial fibrillation ablations. This decision was made after reading John Day's Editorial in the December 2011 issue of Innovations in Cardiac Rhythm Management, where he stated that his lab routinely achieved fluoroscopy times under 10 minutes. Since reading his article, our fluoro times have dropped from an average of more than 45 minutes to a median of 12 minutes, with variation still seen with the type of energy used (RF or cryo) and with paroxysmal versus persistent AF cases. Our push to reduce our times revolved around 1) a healthy competition between the EPs where we posted our fluoro times after each case on a very visible board in the lab, 2) increased trust and reliance of CARTO and Velocity generated anatomy to guide catheter movement, and 3) increased training of our lab staff with ICE so that they can follow our catheters to help ensure appropriate contact. Perhaps the biggest factor in our success was simply the “permission” to use less that we obtained from Dr. Day's editorial. Thanks for emphasizing the issue of radiation safety and helping us to achieve a safer clinical and working environment.

R. Chris Jones, MD
Chair of Cardiovascular Medicine
Centennial Medical Center
Director of EP Research
Sarah Cannon Research Institute
Centennial Heart Cardiovascular Consultants
Nashville, TN