{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:15:22Z","timestamp":1790799322402,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T00:00:00Z","timestamp":1605916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fluoroscopy has been an essential part of every electrophysiological procedure since its inception. However, till now no clear standards regarding acceptable x\u2010ray exposure nor recommendation how to achieve them have been proposed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Current norms and quality markers required for optimal clinical routine can be identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Centers participating in this Europe\u2010wide multicenter, prospective registry were requested to provide characteristics of the center, operators, technical equipment as well as procedural settings of consecutive cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010five centers (72% university clinics, with a mean volume of 526\u2009\u00b1\u2009348 procedures yearly) from 14 European countries provided data on 1788 cases [9% diagnostic procedures (DP), 38% atrial fibrillation (AF) ablations, 44% other supraventricular (SVT) ablations, and 9% ventricular ablations (VT)] conducted by 95 operators (89% male, 41\u2009\u00b1\u20097\u2009years old).<\/jats:p><jats:p>Mean dose area product (DAP) and time was 304\u2009\u00b1\u2009608\u2009cGy*cm<jats:sup>2<\/jats:sup>, 3.6 \u00b1\u20094.8 minutes, 1937\u2009\u00b1\u2009608\u2009cGy*cm<jats:sup>2<\/jats:sup>, 15.3 \u00b1\u200915.5 minutes, 805\u2009\u00b1\u20091442\u2009cGy*cm<jats:sup>2<\/jats:sup>, 10.6 \u00b1\u200910.7 minutes, and 1277\u2009\u00b1\u20091931\u2009cGy*cm<jats:sup>2<\/jats:sup>, 10.4 \u00b1\u200912.3 minutes for DP, AF, SVT, and VT ablations, respectively. Seven percent of all procedures were conducted without any use of fluoroscopy.<\/jats:p><jats:p>Procedures in the lower quartile of DAP were performed more frequently by female operators (OR 1.707, 95%CI 1.257\u20102.318, <jats:italic>P<\/jats:italic> =\u2009.001), in higher\u2010volume center (OR 1.001 per one additional procedure, 95%CI 1.000\u20101.001, <jats:italic>P<\/jats:italic> =\u2009.002), with the use of 3D\u2010mapping system (OR 2.622, 95%CI 2.053\u20103.347, <jats:italic>P<\/jats:italic> &lt;\u2009.001) and monoplane x\u2010ray system (OR 2.945, 95%CI 2.149\u20104.037, <jats:italic>P<\/jats:italic> &lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exposure to ionizing radiation varies widely in daily practice for all procedure. Significant opportunities for harmonization of exposure toward the lower range has been identified.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23411","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T16:40:40Z","timestamp":1605976840000},"page":"36-42","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Fluoroscopy usage in contemporary interventional electrophysiology: Insights from a European registry"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7856-1372","authenticated-orcid":false,"given":"Jedrzej","family":"Kosiuk","sequence":"first","affiliation":[{"name":"Rhythmology Department Helios Clinic Koethen  Koethen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Fiedler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II General Hospital Wiener Neustadt  Wiener Neustadt Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Ernst","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2996-6338","authenticated-orcid":false,"given":"David","family":"Duncker","sequence":"additional","affiliation":[{"name":"Rhythmology and Electrophysiology, Department of Cardiology and Angiology Hannover Medical School  Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Pavlovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiology Univeristy Hospital Center Sestre Milosrdnice  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Guarguagli","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Stegmann","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology Heart Center Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8327-9550","authenticated-orcid":false,"given":"Dawid","family":"Miskowiec","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical University of Lodz  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9350-2437","authenticated-orcid":false,"given":"Rodrigue","family":"Garcia","sequence":"additional","affiliation":[{"name":"Rhythmology Department CHU de Poitiers  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences University of Campania \"Luigi Vanvitelli\"\u2014Monaldi Hospital  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andriy","family":"Yakushev","sequence":"additional","affiliation":[{"name":"Amosov National Institute of Cardiovascular Surgery  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00e1ndor","family":"Szegedi","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center Semmelweis University  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"De Potter","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, OLV Hospital  Aalst Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.01.030"},{"key":"e_1_2_7_3_1","first-page":"1694","article-title":"Effective reduction of fluoroscopy duration by using an 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