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Material and methods We carried out a multicenter survey in 8 French centers. Each patient received a questionnaire to evaluate his perceptions on information and consent, risks associated with pacemaker implantation and ability to perform various routine activities. Results We included 185 patients. The mean age was 75.4 + 10.5 years. A large number of patients considered many routine activities as unsafe, such as sleeping on the side of the pacemaker (12%), swimming (15%), driving automobiles (17%) and passing through metal detectors (47%). Patients had also misconceptions about using induction hobs (38%) and arc welding equipment (32%). As regards medical imaging, 38% did not know if they could undergo MRI exams. As regards medical follow up, 11% of patients thought they did not need heart medications and 17% that they were exempt from monitoring by a cardiologist. In univariate analysis, the factors associated to misconceptions about pacemakers were an age above 75 years and a primary implantation. Conclusion The results of our study highlight patients' misperceptions on life with a pacemaker. This should lead cardiologists to better inform patients at the time of pacemaker implantation. [ABSTRACT FROM AUTHOR]

Background Few data exist about radiation exposure during implantation of cardiac electrical device. No dose reference levels (DRLs) were reported. Purpose to define DRLs and to analyze factors related to an increased radiation dose delivered to patients and medical staff. Methods the Raypace study is a multicenter, prospective observational registry. Using a national database, patient demographic, procedural and radiation data were collected. Fluoroscopy time (FT) and dose-area product (DAP) were registered. Physician/staff exposure was measured using 2 real-time personal dosimeters, one worn under the lead apron and the other one worn outside the apron. Statistical analysis used log-transformation of DAP, FT and DAP/FT ratio. Results A total of 657 procedures from 9 institutions were reviewed. Pacemaker (PM) and cardioverter-defibrillator (ICD) implantation was performed in 481 and 176 patients, respectively. A cardiac resynchronization device was implanted in 153 patients. Fluoroscopy time was similar for PM and ICD implantations. Median fluoroscopy time was 836, 117 and 101 second and median DAP was 1410, 150 and 129 cGy.cm 2 for biventricular, dual chamber and ventricular device implantation, respectively. LAO projection, in addition to AP projection, was used in 47% of the procedures. Five centers out of 9 used collimation. The median Hp (10) effective dose measured outside the lead apron was 4.6 µSv and 0.1 µSv under the lead apron. Regarding CRT implant procedures, four systems out of 6 were responsible for an increased exposure (p<0.001). DRLs were 2600, 338 and 332 cGy.cm 2 for biventricular, dual chamber and ventricular device implantation, respectively. Conclusions DAP reduction was improved with the use of latest generators but needed customized settings. Biventricular device implantation was responsible for the highest radiation exposure. However, radiation exposure during those procedures have decreased as compared to previously reported values. [ABSTRACT FROM AUTHOR]