The Effects of Decreased Frame Rate During Cardiac Catheterization on Patient and Radiation Safety Outcomes

ObjectiveCoronary artery disease (CAD) is an important cause of morbidity and mortality all over the world. Cardiac catheterization is one of the most important treatment modalities in managing CAD. Unfortunately, cardiac catheterization is associated with significant ionizing radiation exposure to both patients and personnel. This study aimed to compare the safety and efficacy of a lower video frame rate of 7.5-fps compared with the standard frame rate of 15-fps. Materials and MethodsWe retrospectively collected and reviewed data from 84 cardiac catheterizations performed between January and February 2020 at a single tertiary center. The patients were divided into two groups based on frame rate: 15-fps (n=42) and 7.5-fps (n=42). We compared the two groups in terms of demographic data, procedural characteristics, radiation dose, and patient outcomes. ResultsCumulative air kerma was significantly lower in the 7.5-fps group (266.576 mGy) compared to the 15-fps group (524.140 mGy), p=0.0018. Similarly, total dose area product was lower in the 7.5-fps group (15335.617 mGy x cm2 compared to the 15-fps group (34784.095 mG x cm2), p = 0.0003. Despite this, total fluoroscopic time did not differ between the two groups 7.74 minutes in the 15-fps group and 8.462 minutes in the 7.5-fps group, p = 0.4023). In addition, 30-day mortality 0% in both groups and there were no differences in the number of repeat PCIs performed within 30 days (6 in 7.5-fps and 3 in the 15-fps group), p = 0.2899. ConclusionDuring cardiac catheterization, a fluoroscopy rate of 7.5-fps is associated with lower radiation dose compared to 15-fps without an associated increase in fluoroscopy time, mortality or repeat PCI. Therefore, interventionalists should consider using a fluoroscopy rate of 7.5-fps during cardiac catheterization.