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Objective: Cardiac catheterization continues to be a major source of radiation exposure for patients with congenital heart disease. As children are more prone to both deterministic and stochastic effects of radiation, every effort should be made to reduce radiation exposure. One way to reduce the radiation dose is to lower the pulse fluoroscopy rate. This study is an examination of the magnitude of radiation exposure with a 3.75 frames per second (fps) pulse fluoroscopy rate and a comparison with the previous 15 fps protocol used for transcatheter atrial septal defect (ASD) closure. Methods: The radiation dose delivered during ASD device closure procedures performed between 2014 and 2016 (Group 1: 3.75 fps fluoroscopy rate) was compared with that recorded in procedures performed between 2011 and 2014 (Group 2: 15 fps fluoroscopy rate). The radiation dose was quantified as air kerma dose (milligray, mGy) and dose area product (DAP; mGy/m2). Results: There were 80 patients in each group. Baseline demographic characteristics and the body weight and height measurements were similar between groups. The mean fluoroscopy time was significantly longer in Group 2. Since the fluoroscopy time was significantly different between groups, the DAP and air kerma dose were indexed according to fluoroscopy time. In Group 1, the DAP and air kerma indexed to body weight values were statistically lower than those of Group 2 (p

Objective: Diagnostic and interventional cardiac catheterization procedures for congenital heart diseases (CHD) are becoming increasingly more popular, and arrhythmia is a well-known complication. This study was an evaluation of the incidence and causative agents of arrhythmia and the subsequent treatment strategies applied during cardiac catheterization. Methods: The catheterization data of all of the patients who underwent diagnostic cardiac catheterization for CHD between January 2012 and 2018 at a single center were examined retrospectively. Results: A total of 1316 children underwent diagnostic cardiac catheterization due to CHD. The median age and body weight was 18 months (6 days-21 years) and 9.9 kg (2.2–135 kg), respectively. Patients with ventricular septal defect (281 patients) and those with tetralogy of Fallot (257 patients) represented 2 major groups in the study population. In 93 (7%) patients, arrhythmia developed during cardiac catheterization. Among them, there were 58 (62%) cases of bradyarrhythmia and 35 (38%) cases of tachyarrhythmia. Arrhythmia was classified as low, high, or major, according to the adverse event severity score; the rates were 2.7%, 4.3%, and 1.2%, respectively. In 36 (39%) patients, there was no need for therapy, whereas 57 (61%) required treatment to eliminate the arrhythmia. Treatment modalities included catheter manipulation in 15, pharmacological therapy in 24, and cardioversion in 3 patients. Eleven patients required cardiopulmonary resuscitation. Temporary pacemaker implantation was required in 2 patients, while 2 others underwent permanent pacemaker implantation secondary to catheterization-related arrhythmia. There were no cases of mortality secondary to catheterization-related arrhythmia. Conclusion: Diagnostic cardiac catheterization in CHD may result in various types of cardiac arrhythmias. The proper management of arrhythmias may reduce morbidity and mortality related to cardiac catheterization.