Efficiency of the RADPAD Surgical Cap in Reducing Brain Exposure During Pacemaker and Defibrillator Implantation.


Journal

JACC. Clinical electrophysiology
ISSN: 2405-5018
Titre abrégé: JACC Clin Electrophysiol
Pays: United States
ID NLM: 101656995

Informations de publication

Date de publication:
02 2021
Historique:
received: 02 12 2019
revised: 15 07 2020
accepted: 03 08 2020
entrez: 19 2 2021
pubmed: 20 2 2021
medline: 19 8 2021
Statut: ppublish

Résumé

This study sought to investigate the RADPAD No Brainer (Worldwide Innovation and Technologies, Overland Park, Kansas) efficiency in reducing brain exposure to scattered radiation. Cranial radioprotective caps such as the RADPAD No Brainer are being marketed as devices that significantly reduce operator's brain exposure to scattered radiation. However, the efficiency of the RADPAD No Brainer in reducing brain exposure in clinical practice remains unknown to date. Five electrophysiologists performing device implantations over a 2-month period wore the RADPAD cap with 2 strips of 11 thermoluminescent dosimeter pellets covering the front head above and under the shielded cap. Phantom measurements and Monte Carlo simulations were performed to further investigate brain dose distribution. Our study showed that the right half of the operators' front head was the most exposed region during left subpectoral device implantation; the RADPAD cap attenuated the skin front-head exposure but provided no protection to the brain. The exposure of the anterior part of the brain was decreased by a factor of 4.5 compared with the front-head skin value thanks to the skull. The RADPAD cap worn as a protruding horizontal plane, however, reduced brain exposure by a factor of 1.7 (interquartile range: 1.3 to 1.9). During device implantation, the RADPAD No Brainer decreased the skin front head exposure but had no impact on brain dose distribution. The RADPAD No Brainer worn as a horizontal plane worn around the neck reduces brain exposure and confirms that the exposure comes from upward scattered radiation.

Sections du résumé

OBJECTIVES
This study sought to investigate the RADPAD No Brainer (Worldwide Innovation and Technologies, Overland Park, Kansas) efficiency in reducing brain exposure to scattered radiation.
BACKGROUND
Cranial radioprotective caps such as the RADPAD No Brainer are being marketed as devices that significantly reduce operator's brain exposure to scattered radiation. However, the efficiency of the RADPAD No Brainer in reducing brain exposure in clinical practice remains unknown to date.
METHODS
Five electrophysiologists performing device implantations over a 2-month period wore the RADPAD cap with 2 strips of 11 thermoluminescent dosimeter pellets covering the front head above and under the shielded cap. Phantom measurements and Monte Carlo simulations were performed to further investigate brain dose distribution.
RESULTS
Our study showed that the right half of the operators' front head was the most exposed region during left subpectoral device implantation; the RADPAD cap attenuated the skin front-head exposure but provided no protection to the brain. The exposure of the anterior part of the brain was decreased by a factor of 4.5 compared with the front-head skin value thanks to the skull. The RADPAD cap worn as a protruding horizontal plane, however, reduced brain exposure by a factor of 1.7 (interquartile range: 1.3 to 1.9).
CONCLUSIONS
During device implantation, the RADPAD No Brainer decreased the skin front head exposure but had no impact on brain dose distribution. The RADPAD No Brainer worn as a horizontal plane worn around the neck reduces brain exposure and confirms that the exposure comes from upward scattered radiation.

Identifiants

pubmed: 33602396
pii: S2405-500X(20)30713-1
doi: 10.1016/j.jacep.2020.08.007
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

161-170

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Camille Lemesre (C)

Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland.

Denis Graf (D)

Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland.

Laurence Bisch (L)

Cabinet Bisch Mock, Nyon, Switzerland.

Patrice Carroz (P)

Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland.

Nicolas Cherbuin (N)

Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland.

Jérôme Damet (J)

Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland; Department of Radiology, University of Otago, Christchurch, New Zealand.

Laurent Desorgher (L)

Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland.

Claudia Herrera Siklody (CH)

Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland.

Mathieu Le Bloa (M)

Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland.

Patrizio Pascale (P)

Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland.

Etienne Pruvot (E)

Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland. Electronic address: etienne.pruvot@chuv.ch.

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