Comparison of operator radiation exposure during coronary sinus catheter placement via the femoral or jugular vein approach

Aims To evaluate and compare operator radiation exposure during the catheter placement in the coronary sinus via the femoral vein with a steerable catheter or the jugular vein with a fixed curve catheter. Methods and results A total of 156 patients undergoing electrophysiological study or radiofrequency catheter ablation were prospectively assigned in a random fashion to either the femoral vein access (FVA) with a steerable curve deca-polar catheter (n = 80) or the jugular vein access (JVA) with a fixed curve deca-polar catheter (n 76). All the catheterization procedures were performed by the same operator who had extensive experience in both accesses. Operator radiation exposure was measured with an electronic radiation dosimeter attached to the breast pocket of the operator on the outside of the lead apron and estimates of the ambient dose equivalent were derived. The operator radiation exposure was reduced significantly by using the FVA compared with the JVA (1.8 +/- 1.3 vs. 8.6 +/- 6.5 mu Sv; P < 0.001). The fluoroscopy time (62.7 +/- 45.8 vs. 61.9 +/- 46.5 s; P = NS) and dose-area product (3.2 +/- 2.3 vs. 3.1 +/- 2.1 Gy cm(2); P = NS) were not statistically different. Conclusion Operator radiation exposure can be significantly reduced by using the FVA approach with a steerable curve catheter compared with the JVA approach with a fixed curve catheter, without increasing the fluoroscopy time and dose-area product.