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INTRODUCTION: Although radiation exposure has been reduced for some electrophysiological procedures (EP) by the use of mapping systems it still remains a concern for electrophysiologists. The aim was to evaluate the impact of a novel X-ray technology on the radiation doses during EP procedures. PATIENTS AND METHODS: 183 consecutive patients undergoing ablation procedures or implantations of cardiovascular implantable devices were included. Procedures were performed using the Artis Q.zen (AQZ, n=93) and the Artis zee (AZ, n=90) X-ray systems (Siemens, Forchheim, Germany). Patients were categorized into four procedure groups -- pulmonary vein isolation, supraventricular tachycardia ablation, cardiac resynchronization therapy device implantation and pacemaker/ implantable cardioverter defibrillator implantation. For all patients standardized settings for fluoroscopy and cine acquisitions were used. Radiation exposure was compared in total and in every group separately. RESULTS: The baseline patient parameters and procedural parameters, namely the procedure duration, the fluoroscopy and cine time were similar between the two systems. The total dose area product and the air kerma across all procedures was reduced by the use of the AQZ angiography system (1068 versus 1730 µGy*m², p=0.169, and 87.5 versus 172.4 Gy, p=0.019). The difference between the two systems was greatest for cine acquisition with roughly 70% for all radiological parameters of the exposure. CONCLUSIONS: Use of novel X-ray technology for standard EP procedures significantly reduces patient doses. The use of this technology further improves safety of angiography based EP procedures. [ABSTRACT FROM AUTHOR]