HRS Press Release

WASHINGTON D.C., July 14, 2026 —Healthcare professionals performing minimally invasive procedures in fluoroscopy laboratories, often called “cath labs,” should no longer have to accept preventable radiation exposure and orthopedic injuries as part of their jobs, according to an expert consensus statement released today that is endorsed by six leading medical societies.

Published today in JSCAI, the Journal of Vascular and Interventional Radiology (JVIR), and JACC: Cardiovascular Interventions, “SCAI/ASE/HRS/SIR/SVS Expert Consensus Statement on Enhanced Radiation Protection: Time for Mandatory and Urgent Action” calls for hospitals, manufacturers, regulators, and professional societies to immediately adopt enhanced radiation protection technologies, modernize radiation safety standards, and strengthen monitoring and reporting practices to better protect the healthcare teams working in fluoroscopy laboratories.

Given the availability of safer technologies, the authors say broader implementation of enhanced radiation protection devices (ERPDs) is both an ethical responsibility and a necessary evolution of ALARA (“As Low As Reasonably Achievable”), the longstanding radiation safety standard that exposures should be kept “as low as reasonably achievable.”

“For decades, we accepted occupational radiation exposure and the physical burden of heavy protective equipment as unavoidable realities of working in a fluoroscopy laboratory,” said David G. Rizik, MD, MSCAI, chair of the writing group. “That is no longer acceptable. Technologies available today can greatly reduce radiation exposure while also addressing the orthopedic injuries associated with traditional lead protection. The question is no longer whether these solutions exist. It is whether we are willing to make protecting healthcare workers the priority it deserves. This consensus makes clear that the time for implementation is now.”

ERPDs reduce radiation exposure through engineering controls rather than relying primarily on personal protective equipment. The consensus statement cites evidence that ERPDs can reduce operator and staff radiation exposure by up to 99 percent.

The statement cited a 2023 SCAI survey of interventional cardiologists, which found that nearly 60 percent reported orthopedic injuries and 17 percent reported limiting their time in the cath lab to reduce radiation exposure. Among women respondents, 28 percent reported being discouraged from working in the cath lab because of pregnancy or considering pregnancy, while 71 percent wanted the option to step away from the cath lab during pregnancy.

“Every clinician and staff member who leaves the fluoroscopy laboratory because of preventable injury or chronic occupational disease represents a loss of expertise that patients depend on, in addition to the immense pain and loss experienced by the clinician and their loved ones,” said James B. Hermiller, MD, MSCAI, cochair of the writing group. “Demand for minimally invasive procedures continues to grow, and the duration and complexity of these procedures are increasing. Maintaining a healthy, experienced workforce will be essential to ensuring patients continue to have access to the lifesaving care these teams provide.”

The statement calls for healthcare organizations and policymakers to:

• Share responsibility among healthcare institutions, manufacturers, regulators, and professional societies for improving occupational safety in fluoroscopy laboratories.
• Adopt ERPDs that can dramatically reduce occupational radiation exposure for physicians and staff.
• Modernize federal and state radiation safety regulations to reflect today’s technology and evidence.
• Measure and report radiation safety performance using real-time dosimetry and standardized quality metrics.
• Design safer fluoroscopy laboratories by integrating enhanced radiation protection into imaging systems and procedure rooms instead of relying primarily on heavy wearable lead.
• Expand education, training, and research to accelerate implementation and continuous improvement.

“The field of electrophysiology has made important progress in reducing radiation exposure, particularly in ablation procedures through the use of low- and zero-fluoroscopy techniques. But that progress has not been uniform. Many device procedures remain fluoroscopy-dependent, and even in low-fluoroscopy environments, clinicians and staff continue to face the orthopedic consequences of wearing heavy lead over years of practice. Tools such as 3D mapping and intracardiac echocardiography have helped advance radiation safety, but they are not universally available, affordable, or supported by training in every lab around the world. Enhanced radiation protection systems offer a practical path forward: they protect the entire team, reduce reliance on heavy personal protective equipment, and allow us to rethink outdated rules that assume lead is the only acceptable safeguard. The Heart Rhythm Society is committed to advancing safer EP laboratories by supporting policies, technologies, and education that protect the health of the entire care team. Workforce safety is a moral, economic, and legal responsibility, and it should be built into the infrastructure of every electrophysiology lab.,” said Kamala P. Tamirisa, MD, FACC, FHRS, HRS member of the writing group.

The multisociety expert consensus statement is endorsed by the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), the American Society of Echocardiography (ASE), the Heart Rhythm Society (HRS), the Society of Interventional Radiology (SIR), and the Society for Vascular Surgery (SVS).

About the Society for Cardiovascular Angiography & Interventions (SCAI)

The Society for Cardiovascular Angiography & Interventions, established in 1978, stands as the primary nonprofit medical society dedicated to representing invasive and interventional cardiology. SCAI’s mission is to guide the global interventional cardiovascular community by fostering education, advocacy, research, and upholding standards for quality patient care. For more than 40 years, SCAI has exemplified professional excellence and innovation worldwide, cultivating a reputable community of over 5,000 members committed to advancing medical science and providing life-saving care for individuals, both adults and children, affected by cardiovascular disease. For more information, visit www.scai.org.

About the Heart Rhythm Society

The Heart Rhythm Society (HRS) is a 501(c)(3) international nonprofit organization and the preeminent leader in science, education, and advocacy for cardiac arrhythmia professionals and patients. HRS continues to be the primary information resource on heart rhythm disorders with a mission to improve the care of patients by promoting research, education, and optimal health care policies and standards, and a mission to eliminate death and suffering due to heart rhythm disorders. Incorporated in 1979 and based in Washington, D.C., it has a membership of more than 9,700 heart rhythm professionals in more than 100+ countries around the world. For more information, visit www.HRSonline.org.