A point that is completely overlooked in most of the questions and comments here - and elsewhere- is the radiation dose involved in heart-related procedures such as bypasses, stent placements, ablations and device placements like pacemakers and Watchmans .
X-ray radiation is harmful for human tissue and can cause cancer. That is why all hospital personnel working in the vicinity of X-ray devices permanently have to carry a dosimeter.
The radiation dose is time dependent, but for example for procedures like catheter ablation it varies between the equivalent of 250 to 1000 static X-rays. Very high, in any case. Placing a few stents equals about 400 X-rays.
A friend radiologist calls it ‘unbelievable’ that the total dose/lifetime per patiënt is not registered in this country (Belgium), and in most other countries, for that matter. I agree with him wholeheartedly. Personnel working around X-ray equipment in hospitals all carry a recorder to monitor their radiation dose. Why is this not recorded and registered for patients?
Is this total dose registered and kept on file where you live? And if not, don’t you think it should be?
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Model52
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My mother was a radiologist in the 1940’s and 1950’s when the equipment primitive and unfortunately often failed to wear her lead apron. My family always blamed that on my mother’s premature death at 32 but it wasn’t from a cancer.
I’ve had 2 ablations, have a pacemaker. X-rays, CT scans and MRIs and thank you but I’ll take the small risk of radiation for the benefits all have offered me. I have recently been offered radiotherapy or surgery, I’ve gone with the surgery because the risk/benefit in that case errs on the side of not accepting radiotherapy which I think does have very high risks or damage although if I had a life threatening cancer I may make a different choice.
As far as I am aware, radiation dosages are recorded for personnel but not for patients in the UK. I imagine the reason for not recording for patients is because of expense. I also think if you are about to undergo complicated surgery for a life threatening conditions which requires X-ray then the last thing on your mind will be the amount of radiation involved in the surgery. I know that every x-ray done in the NHS will be on your NHS patient record but how on earth would you go about recording dentists, private practitioners?
There are also areas in the UK with high levels of natural radiation, cosmic radiation, threat of war and war experiments and exposure from illegal dumping of toxic materials - the former we can do little to nothing about, now the latter I do worry about and feel that the Environment Agency needs far more resources and powers in order to keep illegal dumping in check.
Let’s put things into perspective between the idealistic and what is feasible. If you are that concerned I am sure you could keep your own log.
In 15 years on this forum I've never seen this issue raised by anyone. I'd be more worried about getting a cancer from exposure to the sun. Irrelevant in UK ........... but where I come from in Australia kids are indoctrinated from pre school age to 'slip, slap, slop' a reference as to how essential it is to put on sun cream and the need to cover up when in the sun.
Certainly in Sydney ( hometown) in summer a skin burn time can be as little as 8 minutes ..... do that often enough and I'm inclined to take radiation from hospital equipment anyday.
Good point. Let’s look at the two kinds of radiation harm a little more in detail!
First of all: the comparison is not straightforward because ionizing radiation (like X-rays) and ultraviolet (UV) radiation affect the body differently.
Here’s a breakdown:
• The dose from a catheter ablation is usually 5–20 millisieverts (mSv) of ionizing radiation.
• UV radiation doesn’t have a comparable “dose” in millisieverts, but we can estimate its harmful effects in terms of UV Index exposure or the time required to cause skin damage (e.g., sunburn).
Sunlight Comparison:
• A single day of high UV exposure (e.g., UV Index 10) might result in about 0.01 mSv of effective radiation dose to the skin, primarily causing localized damage (sunburn).
• Ionizing Radiation (X-rays): Can damage internal tissues and DNA throughout the body, increasing long-term risks like cancer.
• UV Radiation: Primarily affects the skin and eyes, causing localized damage such as sunburn or an increased risk of skin cancer (melanoma, basal cell carcinoma).
• Daily UV exposure from sunlight adds up over a lifetime and is the leading cause of skin cancer.
• Ionizing radiation from medical procedures is generally limited to a few events in a lifetime, so its long-term risks are smaller unless repeated procedures that involve long durations are performed. Hence my call for a registration of the total dose!
Analogy for Perspective
• A catheter ablation’s dose is roughly equal to spending 500-2000 full summer days in the sun with high UV exposure in terms of total radiation energy absorbed.
However, the biological effects differ because sunlight damages surface tissues (skin), while X-rays penetrate and affect deeper tissues.
To sum it up: both forms of radiation are harmful in their own ways, but their effects and risks aren’t directly equivalent. UV is a concern for cumulative, long-term skin damage, while ionizing radiation from medical procedures poses a systemic risk and is typically limited to essential treatments.
Doctors follow directives which limit the amount of radiation you can be exposed to during an ablation. 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.
These techniques are indeed increasingly replacing or complementing traditional fluoroscopy in many centers, driven by advances in technology and growing awareness of the long-term risks of radiation exposure.
But MRI-guided catheter ablation is still developing and is not yet widely adopted due to technical and logistical challenges, including the need for specialized (non-metal) MRI-compatible equipment.
Ultrasound ICE improves safety by providing direct visualization of the heart and reducing risks like cardiac perforation or damage to the heart.
But there goes the same: not many centers use this technique yet.
Well best not go to Australia then ! You'd have skin cancers bursting out all over within minutes of getting out of the airline terminal. See my earlier comments. In anycase if you knew you were vulnerable to the ravages of the sun you'd know to keep covered anyway even on a regular cloudy summers day. But then there is genetics - again OBVIOUSLY if any member of a family had a tendency to skin blemishes (like moles as I have) even then one would think they'd take preventive measures against unneccessary exposure. But then my discipline has been drilled into me from umpteen Australian summers.
Yes, I'm aware of all these things. But my reply was not about my personal situation. Just correcting what any dermatologist would call a dangerously misleading statement. Anyway, none of this is really relevant to the thread ; UV is nothing to do with X rays.
In 2019 the ultra-sound operator Jade saw a shadow on my Thyroid. During a carotid artery which were ckear.
I was quizzed by my surgeon did I work in radiology?
No. But some years ago I had an old Chiropracter's Xray performed. I had to open my mouth!
In my life I have had many xrays etc. Lately CT scans.
Like steroid use someone should be keeping count.
Is that why after 3 ablations at Auckland Hospital my friend was told no more ablations for you!
I read that the surgeons doing the procedures can get ill from the radiation and that is why a glass was put between patient and him. Those that wear the heavy apron get other injuries. The weight of the apron is huge.
Radioactive Iodine Treatment was offered after Thyroidectomy. I said no I was of low risk category. Risks are leukaemia, damage to parathyroid, throat, voice or swallowing etc.
We have a right to refuse.
With ablation I have not seen the radiation used or the risks from it. Many people have had more than 1 ablation.
If I read about those people having more than one ablation -sometimes 3 or 4!- I always wonder if they have been duly informed of all the possible risks involved, including the massive dose of radiation. And even more so: if they have exhausted all other, less invasive, solutions. I’m afraid not. I have the advantage of having a very experienced cardiologist as one of my best friends. He has Afib. He would never consider an ablation, let alone 3 or 4!
Exactly what I did from day one ... I was given the option of ablation or medication for life. Didn't fancy either but opted for meds for life. Sorted!
That's all very well if the meds control the afib but if you are like me and they didn't and the episodes of fast heart rate came frequently and lasted more than 36 hours each time, I think you may reconsider as that is no quality of life, believe me I've experienced it!
After 2 different Beta Blockers and 24hr monitors that neither showed that they were controlling my rapid H/R. 186 and 156 bpm is well over the 100bpm which is acceptable, But 47avg bpm at Night. Perhaps that is why the hospital h/rate for my area left me!
Hi there, I am really limited to what I can take as I have low BP. The only drug (in limitation) was a potassium channel blocker - Sotalol. They couldn't increase it anymore because of my BP and it wasn't controlling it. The EP said I had little alternative other than Amodiarone (think that's what it's called) and that has some very nasty side effects and couldn't be taken long term.
At least we can keep our own record of procedures and take a decision on whether we want the next one or consider we have had enough.
Personally I am in confusion over the conflicting messages on what is worth the risk and what should be avoided. I therefore take the view avoid unless an emergency. eg I reduce the regular dental X-rays, which are offered and accept the risk of detecting early decay.
On sun risk, I minimise suncream unless in it for several hours and then I use one a dermatologist recommended which I don't think is in the High Street. I have been influenced here by Weston A Price, who are a body of ethical alternative practitioners and question the side effects of most creams.
I regard sun creams as poison imbibed through the skin rather than through the digestive tract. They also poison the environment and are totally unnecessary. People should be educated into the bebefits of sensible sun exposure depending on their skin type and time of year and cover their skin or stay in the shade once they have had enough sun. But they make too much money so fat chance of that.
Yep. The Covid jabs have been a huge educational wake-up call for me on all product marketing and how it is aided by Public bodies. I now educate myself reading independent commentators.
To be honest, if I have a x-ray or scan, I'm under the assumption that it is a medical necessity, as hospitals don't do these, often expensive procedures for nothing. With that in mind, my main concern is that they are able to find and treat the issue by whatever means, particularly if life threatening,
Of course hospital staff will have things monitored as they are exposed to radiation on a regular basis.
As you seem to be very familiar with all the weights and measures involved, I would imagine you would be able to monitor your own exposure, if it was that much of a concern to you.
I’m afraid I have to disagree with the ‘they don’t do expensive procedures for nothing’ part. I had 3 stents placed after a heart attack. Recent research has shown that medication after such an event is just as efficient as stenting, with no difference in mortality or quality of life.
The same goes for most of the ablations. Two procedures with a massive dose of radiation involved… Both of them replaceable by (correct) pharmaceutical approaches.
I'm not sure what pharmaceutical approach would replace the cardiologist being able to see what's going on inside your body at a point where they need to see, rather than guess.Is this research suggesting you didn't need stents something you read or was imparted to you by a medical professional?
For me, it boils down to a risk/reward scenario. If you want to make decisions based on things other than those recommended by your health/cardiac team, that's fine. I have questioned medication options previously with mine, but worrying about the odd x-ray or scan is not high on my list of worries........ just my opinion.
I disagree about the ablation, sorry, some of us with fast heart rates can't be controlled by medication I am living proof of that. For quality of life the safer option was ablation, I didn't really have an option
The exceptions are indeed people with flutter or high-rate Afib, that cannot be lowered in any way with medication. But luckily that is a very small minority.
However, I often read posts here of people who only have two or three Afib-incidents/year, with heart rates that could be brought down to within acceptable limits with betablockers ore ACE-inhibitors, but they still go on to have an ablation. That seems far from logical to me.
I was limited in the drugs I could take because of low BP so was put on Sotalol that didn't control my AF and flutter. It couldn't be increased any more so expect I am in the minority group. The ablation seems to have done the trick and I have my life back, at least for now. I wouldn't have chosen it but had to be guided by my expert EP
I think most people either are unaware of the need for X-rays during a cardiac ablation, or accept there is no alternative. I always ask, though, even for dental work. When CT has been mentioned, on occasion, I always ask if MRI isn't an option, although the last abdominal CT was with a new machine that, I was told, used a mere 10% of the X-ray dose compared with the previous one - so technology is working for us.
There was a note in my hospital /ICU records following open heart surgery, ablation & Atriclip, and having multiple post-op daily x-rays, that I was at the threshold for radiation exposure so I suppose the clinicians are aware of limits and record as required.
As far as I can tell it's not recorded in England. However , because I have very bad spinal problems, I've had dozens of x rays and CT scans as well as the necessary scans for heart problems and stents. Only once, around 20 years ago has the x ray department mentioned the number of x rays I've had as being far too many. I've had numerous since then but all were very necessary. I can't have MRI scans so I have CT scans instead; 3 in the past 5 years. Have I had t oo many? Yes probably but all were deemed essential. Will I have more? Absolutely if they help me to get treatment.
MRI-scans are reasonably harmless. Is there a reason why you cannot have any? All other scans involve radiation. So it’s necessary to consider the necessity versus the disadvantages.
Radiation from medical sources has little or no effect on older peoples tissue and organs to the best of my knowlege and as a general rule older people pass away naturally before anything sinister gets a chance to show up anyway. The problem lies in younger people children and young adults as they have a long time ahead of them for any problems to develop.
Doctors follow directives which limit the amount of radiation you can be exposed to during an ablation. 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.
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Ablation booked at the freeman 1st Nov - Terrified can’t stop worrying 
Bisoprolol - weird side effects on low dose?
Iatrogenic pneumothorax from pacemaker procedure. 
Loss of confidence after ablation procedures—bisoprolol and fatigue.
3rd ablation 
