Robotic radiation shielding system reduces radiation-induced DNA damage in operators performing electrophysiological procedures.

Fluoroscopically guided electrophysiology (EP) procedures expose operators to low doses of ionizing radiation, which can induce DNA double-strand breaks (DSBs) and raises increasing concerns regarding potential health risks. A novel robotic radiation shielding system (RSS) was developed to provide full-body protection by encapsulating the imaging beam and blocking scattered radiation. This study aimed to compare the levels of blood lymphocytes expressing DSB markers, pATM and γ-H2AX, in operators performing EP-procedures with and without RSS. Radiation dose exposure was significantly higher without RSS (p = 0.0278). The level of cells expressing pATM and γ-H2AX was linear correlated with radiation exposure, with neither marker detected at doses below 13.4 µSv. Without RSS, the level of pATM or γ-H2AX positive cells increased significantly immediately after the procedure (8.6-fold, p < 0.0001 and 3.4-fold, p = 0.0279, respectively). After 4 h, marker levels were moderately reduced, and at 24 h, pATM returned to baseline and γ-H2AX decreased to 1.9-fold over baseline (p = 0.9739). In contrast, with RSS, no significant elevation in pATM or γ-H2AX positive cells was observed, suggesting no significant DSB formation. In conclusion, the use of an effective full-body protection system during fluoroscopically guided EP-procedures may help mitigate DSB formation and reduce the genotoxic health risks for operators.