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Table 2 Factors modulating doses in cardiac catheterization lab

From: The Radiation Issue in Cardiology: the time for action is now

   Lower doses Higher doses
OPERATOR-DEPENDENT Operator background Expert Beginner
  Cath-lab director Radiation aware and conscious Not radiation aware and conscious
  Written records Includes KAP Omits KAP
  Arterial Approach Trans-Femoral Trans-Radial
  Pulsed Fluoroscopy Low rate (12.5/s) High rate (25/s)
  Patient to image intensifier or flat panel distance As small as possible Large
  Ventriculography No Yes
  Cine-duration Short Long
  Magnified views Few Many
  Projection Ant, RAO Lateral, LAO
  Dose audit Yes No
PATIENT-DEPENDENT Body habitus Lean Obese
  Coronary lesion to be dilated Simple and single Complex and multiple
  Arrhythmic lesion to be ablated Supraventricular tachycardia Atrial fibrillation, ventricular tachycardia
TECHNOLOGY X-ray system Inspected for QC and maintained Not tested for QC and not maintained
  1. KAP = Kerma Area Product; LAO = Left anterior oblique projection; RAO = Right anterior oblique projection; QC = quality control.