Abstract
Since the introduction of 3D mapping systems, the use of x-rays in electrophysiology procedures has significantly decreased. The goal of this study was to analyze the frequency of x-ray use in pediatric electrophysiology in relation to age or body mass, indication for the procedure, and arrhythmia substrate. This retrospective, cross-sectional study included all pediatric procedures in two centers, Gottsegen Cardiovascular Center, Budapest, Hungary and Sestre milosrdnice University Hospital Center, Zagreb, Croatia. Patient data included weight, age, sex, presence of structural heart disease, indication for the electrophysiology study, arrhythmia substrate, and x-ray use. A total of 914 participants were analyzed, mean age 13.25 years and mean mass 53.20 kg. Of all procedures, 62.04% were performed without and 37.96% with fluoroscopy. There were no statistically significant differences in the frequency of x-ray use when comparing the groups by sex (p=0.181), age (p=0.380) or mass (p=0.120). Left-sided accessory pathways required x-ray use most frequently, whereas unknown substrates and of the known substrates atrioventricular nodal reentry tachycardia required it least frequently (p<0.001). Younger or smaller children were not irradiated more frequently during electrophysiology procedures performed with 3D mapping systems. In conclusion, there is no reason to postpone the procedure based on radiation frequency use.