Interventional electrophysiology offers a great variety of treatment options to patients suffering from symptomatic cardiac arrhythmia. Catheter ablation of supraventricular and ventricular tachycardia has globally evolved a cornerstone in modern arrhythmia management. Complex interventional electrophysiological procedures engaging multiple ablation tools have been developed over the past decades. Fluoroscopy enabled interventional electrophysiologist throughout the years to gain profound knowledge on intracardiac anatomy and catheter movement inside the cardiac cavities and hence develop specific ablation approaches. However, the application of X-ray technologies imposes serious health risks to patients and operators. To reduce the use of fluoroscopy during interventional electrophysiological procedures to the possibly lowest degree and to establish an optimal protection of patients and operators in cases of fluoroscopy is the main goal of modern radiation management. The present manuscript gives an overview of possible strategies of fluoroscopy reduction and specific radiation protection strategies.

Clinic for Electrophysiology Herz und Diabeteszentrum NRW Georgstr 11 Bad Oeynhausen 32545 Germany

Department of Cardiology and Angiology University Hospital Freiburg Bad Krozingen Germany

Department of Cardiology Ceske Budejovice Hospital and Faculty of Health and Social Sciences University of South Bohemia Ceske Budejovice Czech Republic

Department of Electrophysiology German Heart Center Technical University Munich Germany

Division of Cardiology Department of Medical Sciences 'Citta della Salute e della Scienza di Torino' Hospital University of Turin Torino Italy

German Center for Cardiovascular Research Partner Site Hamburg Kiel Lübeck Lübeck Germany

University Heart Center Lübeck Department of Rhythmology University Hospital Schleswig Holstein Luebeck Germany

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