{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:31:51Z","timestamp":1789201911150,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T00:00:00Z","timestamp":1363651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Ablation for supraventricular tachycardia (SVT) relies upon fluoroscopy (fluoro), which exposes the patient and staff to ionizing radiation. The objective of this work was to present a new \u201cALARA\u2014As Low As Reasonably Achievable\u201d protocol with alterations to fluoroscopic x\u2010ray parameters to reduce dose without an electroanatomical (EAM) approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients &lt;21 years of age undergoing ablation of SVT at our institution from June 2011 to April 2012 were included. EAM was not utilized in any case. An ALARA protocol of low frame rates (2 or 3 fps), low fluoro dose\/frame (10\u201318 nGy\/frame), and other techniques aimed at reducing use of fluoroscopy were employed. Demographics, procedural, and radiation data were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two patients underwent ablation and were studied. Median age was 14.1 years (range 4.8\u201321.1 years), weight was 51 kg (range 18.2\u201375 kg), and body surface area was 1.51 m<jats:sup>2<\/jats:sup> (range 0.72\u2013 1.94 m<jats:sup>2<\/jats:sup>). Seventeen (41%) had Wolff\u2010Parkinson\u2010White syndrome, 14 (33%) <jats:italic>atrioventricular nodal reentrant tachycardia<\/jats:italic>, and 11 (26%) concealed pathways. Median procedural time was 114 minutes (57\u2013246 minutes). Median dose area product (DAP) for posterioanterior and lateral fluoroscopy was 343.2 uGym<jats:sup>2<\/jats:sup> (range 38.2\u20133,172 uGym<jats:sup>2<\/jats:sup>); the median air Kerma product (K) was 45.4 mGy (range 6.7\u2013567.5 mGy). DAP and K are lower than prior data from EAM and fluoroscopy techniques. The acute success rate was 95%; no procedural complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An ALARA protocol for ablation of SVT reduced radiation to below levels previously reported for combined EAM\/fluoro approaches. Success rates were excellent with no complications and without the costs of EAM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12124","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T17:19:04Z","timestamp":1363713544000},"page":"688-694","source":"Crossref","is-referenced-by-count":37,"title":["Reducing Patient Radiation Dosage during Pediatric SVT Ablations Using an \u201cALARA\u201d Radiation Reduction Protocol in the Modern Fluoroscopic Era"],"prefix":"10.1111","volume":"36","author":[{"given":"LAURA A.","family":"GELLIS","sequence":"first","affiliation":[{"name":"Pediatric Electrophysiology Service, Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital at Montefior Albert Einstein College of Medicin  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SCOTT R.","family":"CERESNAK","sequence":"additional","affiliation":[{"name":"Pediatric Electrophysiology Service, Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital at Montefior Albert Einstein College of Medicin  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GREGORY J.","family":"GATES","sequence":"additional","affiliation":[{"name":"Pediatric Electrophysiology Service, Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital at Montefior Albert Einstein College of Medicin  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LYNN","family":"NAPPO","sequence":"additional","affiliation":[{"name":"Pediatric Electrophysiology Service, Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital at Montefior Albert Einstein College of Medicin  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ROBERT H.","family":"PASS","sequence":"additional","affiliation":[{"name":"Pediatric Electrophysiology Service, Division of Pediatric Cardiology, Department of Pediatrics, The Children's Hospital at Montefior Albert Einstein College of Medicin  Bronx New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2002.01000.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-9813(01)00083-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001573-200401000-00013"},{"key":"e_1_2_8_5_1","first-page":"652","article-title":"Guidelines for Clinical Intracardiac Electrophysiological and Catheter Ablation Procedures. 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