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13 March 2010

Answer to Question #3390 Submitted to "Ask the Experts"

Category: Medical and Dental Patient Issues — Diagnostic X Ray and CT

The following question was answered by an expert in the appropriate field:

What is the maximum amount of fluoroscopy time with 80 kVp and 2.2 mAs used on a patient having a pacemaker implanted at which you can actually do damage to the patient?

It is impossible to adequately answer this question as there are a great number of medical and technical variables that can influence the implant procedure and fluoroscopic exposure times. As noted on the Cleveland Clinic implant information page, the implant procedure alone can take from two to five hours. Of course, during this time the patient is not being continually exposed to fluoroscopic radiation. Rather, fluoroscopy is only used during those periods when the leads are being pushed through the blood vessels into the heart. In addition, the x-ray beam will not be held in any single location for an extended period of time, which further lessens the chance of harming the patient.

While extended fluoroscopic exposures may result in injuries to patients, Table I of the Food and Drug Administration's information alert for physicians of September 9, 1994, "Avoidance of Serious X-Ray-Induced Skin Injuries to Patients During Fluoroscopy-Guided Procedures," pacemaker implantations are not listed as high-risk procedures. As noted in Table II, several hours of exposure at low dose rates are required to cause radiation-induced injuries.

John Jacobus, MS, CHP

Answer posted on 26 February 2004. The information and material posted on this Web site is intended as general reference information only. Specific facts and circumstances may alter the concepts and applications of materials and information described herein. The information provided is not a substitute for professional advice and should not be relied upon in the absence of such professional advice specific to whatever facts and circumstances are presented in any given situation. Answers are correct at the time they are posted on the Web site. Be advised that over time, some requirements could change, new data could be made available, or Internet links could change. For answers that have been posted for several months or longer, please check the current status of the posted information prior to using the responses for specific applications.