SUSPENDED lead suits may substantially reduce radiation exposure for clinicians performing complex heart procedures, according to new research examining occupational safety during left atrial appendage occlusion.
Left atrial appendage occlusion is a minimally invasive procedure used to reduce stroke risk in patients with atrial fibrillation. The procedure often relies on imaging guidance from an interventional echocardiographer, who must stand close to the patient and radiation source during fluoroscopy. This proximity can lead to repeated occupational exposure to ionising radiation over time.
Suspended Lead Suits Lower Radiation Exposure
In the study, researchers evaluated whether suspended lead suits could provide better radiation protection than traditional lead apron shielding. Suspended systems are mounted from overhead structures, allowing clinicians to stand within the protective barrier while avoiding the physical strain associated with heavy wearable aprons.
The cross-sectional study analysed radiation exposure during 125 left atrial appendage occlusion procedures performed at a single specialised cardiac centre. During 95 procedures, interventional echocardiographers used suspended lead suits, while 30 earlier procedures were conducted using conventional lead aprons.
Radiation exposure was measured using head-level dosimeters worn by the clinicians during each case.
Large Reductions in Radiation Dose
The findings showed a marked reduction in radiation exposure when suspended lead suits were used. The median radiation dose recorded at head level was essentially zero when clinicians used the suspended systems. In contrast, clinicians wearing traditional lead aprons experienced a median dose of 10.6 μSv per procedure.
Radiation exposure was undetectable in 60% of cases using suspended lead suits, while no cases using traditional lead aprons recorded undetectable exposure.
Higher radiation doses were also far less common with the suspended systems. No procedures using suspended suits produced doses of 20 μSv or more, compared with nearly one third of procedures performed using standard lead apron protection.
Implications for Occupational Safety
Occupational radiation exposure remains an ongoing concern for clinicians involved in fluoroscopy-guided procedures. Over time, repeated exposure may increase the risk of radiation-related health effects, particularly for specialists who frequently work near imaging equipment.
The findings suggest that suspended lead suits could provide a more effective shielding strategy for interventional echocardiographers during structural heart procedures. By significantly reducing radiation exposure at the head level, these systems may help improve long-term occupational safety while maintaining procedural imaging guidance.
Further research may help determine whether similar benefits extend to other interventional specialties that rely heavily on fluoroscopy.
Reference
McNamara DA et al. Suspended lead suits and radiation exposure in interventional echocardiographers. JAMA Netw Open. 2026 Mar 2;9(3):e2558134.
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