Introduction

Occupational doses of radiation in cardiac procedures guided by fluoroscopy are the highest registered among medical staff using X-rays.1–5 Electrophysiologists and interventional cardiologists are the group with the highest exposure. Patient and operator exposure are closely related. Higher doses to the patient results in more scatter radiation and increased exposure to the operator. Patients with an elevated body mass index are frequently encountered in the catheterisation laboratory and need more radiation energy to obtain a good quality image, resulting in increased scatter radiation generation during the procedure.6 Patient exposure to low-dose ionising radiation from cardiac procedures may be associated with increased risk, mainly if the exposure occurs at a young age.7 While every effort should be taken to obtain high-quality images, it is important to try and decrease the amount of procedure-related radiation exposure and protect the working staff (ie, cardiologists, cardiac technicians, radiographers, nurses and trainees) in the cardiac catheterisation laboratory. In this article we discuss these issues and outline strategies to reduce patient and staff exposure.