Radiation Exposure During an Ablation Procedure
By Steve S. Ryan, PhD
Exposure to radioactivity during an ablation used to be a legitimate concern. (Doctors and nurses wore lead aprons during an ablation.) Back in 2003, a typical A-Fib ablation resulted in around 50 minutes of fluoroscopy time. 1 One hour of fluoroscopy imaging is associated with a lifetime three-in-ten thousand chance (0.03%) of developing a fatal malignancy, and a risk of passing on a genetic defect of 20 per 1 million births, 2 These risks were considered relatively small compared to the risks of being in A-Fib, antiarrhythmic drug therapy, and/or surgery. 3
Doctors follow directives which limit the amount of radiation you can be exposed to during an ablation. If you get close to exceeding these limits, they will stop the ablation (though this rarely happens).
But many centers today use much less or no fluoroscopy at all. Instead many use 3D non-fluoroscopy (no radiation) imaging techniques such as Intracardiac Echocardiography (ICE), and Magnetic Resonant Imaging (MRI). You need to check with your A-Fib center as to how much radiation their typical A-Fib ablation patient is exposed to. The radiation dose for a typical A-Fib ablation is estimated to be 18.4 mSv. 2 However, the radiation amount at your A-Fib center will vary depending on what type of imaging equipment they use.
Once you learn what amount of ablation radiation you might be exposed to at your A-Fib center, then you can compare it to the following to determine if you should be concerned:
|TYPE OF RADIATION EXPOSURE||AMOUNT (mSv units)|
|Average Background Radiation/year||2.4 mSv|
|Chest X-Ray Radiation||0.02-0.2 mSv|
|Full-mouth Dental X-Ray||0.03-0.2 mSv|
|Spinal X-Ray Radiation||1.5 mSv|
|Heart CT Scan Radiation (100-600 Chest X-rays)||12.0 mSv|
|25.5 min. fluoroscopy during an A-Fib Ablation||15.2 mSv|
But bear in mind that, even a one hour-long exposure to fluoroscopy, is a relatively small risk compared to the risks of being in A-Fib, antiarrhythmic meds, and/or surgery.
(The author did a very unscientific survey of the A-Fib medical centers in his area. The average seemed to be 10-20 minutes of fluoroscopy time [for those who used fluoroscopy] for an A-Fib ablation, but more complicated cases could expose patients to 60(+) minutes of fluoroscopy time.)
Before and After: Protecting Yourself from Radiation Damage
You can take measures before and after your ablation to help protect yourself from radiation damage. Since much of the cancer-causing damage from ionizing radiation is from hydroxyl free radicals, it’s recommended to take antioxidant supplements to neutralize them.
A typical plan is to take the following natural supplements every six hours for at least 24 hours before and after your radiation exposure. These are available without a prescription from health food stores. Check with your doctor before taking any supplements.
- Vitamin C 1000 mg
- Lipoic Acid 400 mg
- N-Acetyl Cysteine 200 mg
- Melatonin 3 mg
DO Low Doses of Radioactivity Combat Cancer?
In 2004, the Journal of American Physicians and Surgeons published an amazing study of radiation exposure that calls into question the prevailing “linear no-threshold” (LNT) theory of radiation. 4
The story starts 20 years earlier in 1983 when180 apartment building were built in Taiwan. But somehow highly radioactive Cobalt-60 was mixed into the concrete. The 10,000 people who lived in these apartments for 9-20 years received an average of 74 millesieverts (mSv) of radiation a year (a typical catheter ablation using fluoroscopy produces around 15 mSv 5 but much less for non-x-ray imaging systems).
Amazingly, the cancer rates of people living in these highly radioactive buildings were 3.6% of prevailing Taiwanese rates. This is a reduction in cancer rates of 96.4%. This phenomenon is perhaps explained by the theory of hormesis which holds that intermediate levels of radioactivity actually stimulate life and improve health.
(Editor’s Note: The nuclear theory that any level of radiation is cumulatively damaging may not be valid (the Linear No Threshold theory). The levels of radiation received during a typical catheter ablation may not be dangerous, but may even be healthful.)
Last updated: Monday, March 25, 2013
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- Macle, L et al. “Radiation Exposure During Radiofrequency Catheter Ablation for Atrial Fibrillation.” Pacing and Clinical Electrophysiology, March 28, 2003. Volume 26, Issue 1p2, Pages 288-291.↵
- Shapira, AR. “Catheter Ablation of Supraventricular Arrhythmias and Atrial Fibrillation.” American Family Physician, November 15, 2009, p. 1089. http://www.aafp.org/afp/2009/1115/p1089.html↵
- Calkins, H. et al. “Radiation exposure during radiofrequency catheter ablation of accessory atrioventricular connections.” Circulation, Vol. 84, 2376-2382, 1991.↵
- Shapira, A R. Catheter Ablation of Supraventricular Arrhythmias and Atrial Fibrillation. American Family Physician, November 15, 2009, p. 1089. http://www.aafp.org/afp/2009/1115/p1089.html.↵
- Chen, W. et al. Is Chronic Radiation an Effective Prophylaxis Against Cancer? Journal of American Physicians and Surgeons, Spring 2004 Vol 9, Issue 1, p6. Last accessed Sept. 13, 2012 http://www.jpands.org/jpands0901.htm↵
- Efstathopoulos, EP, et al. “Patient and staff radiation dosimetry during cardiac electrophysiology studies and catheter ablation procedures: a comprehensive analysis.” Europace (The European Society of Cardiology), 2006 8(6): 443-448; doi:10.1093/europace/eul041↵