The Inverse Correlation Between the Duration of Lifetime Occupational Radiation Exposure and the Prevalence of Atrial Arrhythmia

Rithika Thirumal; Catherine Vanchiere; Ruchi Bhandari; Sania Jiwani; Ronald Horswell; San Chu; Surbhi Chamaria; Pavan Katikaneni; Marjan Boerma; Rakesh Gopinathannair; Brian Olshansky; Steven Bailey; Paari Dominic

doi:10.3389/fcvm.2022.863939

The Inverse Correlation Between the Duration of Lifetime Occupational Radiation Exposure and the Prevalence of Atrial Arrhythmia

Front Cardiovasc Med. 2022 May 30:9:863939. doi: 10.3389/fcvm.2022.863939. eCollection 2022.

Authors

Rithika Thirumal^{1

2}, Catherine Vanchiere^{2

3}, Ruchi Bhandari⁴, Sania Jiwani⁵, Ronald Horswell⁶, San Chu⁶, Surbhi Chamaria⁷, Pavan Katikaneni^{2

8}, Marjan Boerma⁹, Rakesh Gopinathannair¹⁰, Brian Olshansky¹¹, Steven Bailey^{2

5

8}, Paari Dominic^{2

8}

Affiliations

¹ Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, United States.
² School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States.
³ Department of Internal Medicine, Temple University, Philadelphia, PA, United States.
⁴ Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, United States.
⁵ Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States.
⁶ Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States.
⁷ Mercy Hospital, Fort Smith, AK, United States.
⁸ Center for Cardiovascular Diseases and Sciences, Louisiana State University Health Sciences Center, Shreveport, LA, United States.
⁹ Department of Pharmaceutical Sciences, University of Arkansas Medical Center, Little Rock, AK, United States.
¹⁰ Department of Cardiology, Kansas City Heart Rhythm Institute, Overland Park, KS, United States.
¹¹ Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.

Abstract

Objective: Advancements in fluoroscopy-assisted procedures have increased radiation exposure among cardiologists. Radiation has been linked to cardiovascular complications but its effect on cardiac rhythm, specifically, is underexplored.

Methods: Demographic, social, occupational, and medical history information was collected from board-certified cardiologists via an electronic survey. Bivariate and multivariable logistic regression analyses were performed to assess the risk of atrial arrhythmias (AA).

Results: We received 1,478 responses (8.8% response rate) from cardiologists, of whom 85.4% were male, and 66.1% were ≤65 years of age. Approximately 36% were interventional cardiologists and 16% were electrophysiologists. Cardiologists > 50 years of age, with > 10,000 hours (h) of radiation exposure, had a significantly lower prevalence of AA vs. those with ≤10,000 h (11.1% vs. 16.7%, p = 0.019). A multivariable logistic regression was performed and among cardiologists > 50 years of age, exposure to > 10,000 radiation hours was significantly associated with a lower likelihood of AA, after adjusting for age, sex, diabetes mellitus, hypertension, and obstructive sleep apnea (adjusted OR 0.57; 95% CI 0.38-0.85, p = 0.007). The traditional risk factors for AA (age, sex, hypertension, diabetes mellitus, and obstructive sleep apnea) correlated positively with AA in our data set. Cataracts, a well-established complication of radiation exposure, were more prevalent in those exposed to > 10,000 h of radiation vs. those exposed to ≤10,000 h of radiation, validating the dependent (AA) and independent variables (radiation exposure), respectively.

Conclusion: AA prevalence may be inversely associated with radiation exposure in Cardiologists based on self-reported data on diagnosis and radiation hours. Large-scale prospective studies are needed to validate these findings.

Keywords: atrial arrhythmia; electrophysiologists; fluoroscopy; interventional cardiologists; invasive cardiology; radiation.