Introduction: Fluoroscopy assisted procedures have increased occupational radiation exposure among Cardiologists. Radiation has been linked to cardiovascular complications but its effects on cardiac rhythm has not been extensively explored.Hypothesis: We hypothesized that radiation exposure is associated with increased risk of atrial arrhythmias (AA) despite appropriate leaded body coverage.Methods: Demographic, social, occupational, and medical history was collected from board-certified cardiologists via an electronic survey. Bivariate and multivariable logistic regression analyses were performed.Results: We received 1478 responses from cardiologists; 85.4% were males, 79% were White and 66.1% were ≤65 yrs of age. 35.6% of respondents were interventional cardiologists and 16.4% were electrophysiologists, and of those, 92.2% wore lead apparel during all times of radiation exposure. Cardiologists >50 yrs of age, with >10,000 hours of occupational radiation exposure, had a significantly lower prevalence of AA compared to those with ≤10,000 hours of radiation exposure (11.1% vs 16.7%, p=0.019). A multivariate logistic regression was performed and among cardiologists >50 years of age, exposure to >10,000 radiation hours was significantly associated with lower likelihood of AA, after adjusting for age, sex, DM, HTN and OSA (adjusted OR 0.57; 95% CI 0.38 - 0.85, p=0.007). Traditional risk factors such as age, sex, HTN, DM and OSA were more prevalent in those with AA and cataracts, a well-established complication of radiation exposure in cardiologists, was more prevalent in those exposed to >10,000 radiation hours compared to those exposed to ≤10,000 radiation hours, validating the dependent (AA) and independent variables (radiation exposure), respectively.Conclusions: Radiation exposure in Cardiologists with appropriate lead apparel is inversely related to AA. Large scale prospective studies are needed to validate our findings.