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Radiation-induced effects in multiprogrammable pacemakers and implantable defibrillators.
F Rodriguez1, A Filimonov, A Henning
1Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire.
Pacing and Clinical Electrophysiology : PACE
|December 1, 1991
Summary
This study assessed the radiation tolerance of pacemakers and implantable cardioverter defibrillators (ICDs). Shorter channel length complementary metal-oxide semiconductor (CMOS) integrated circuit technology demonstrated superior resistance to ionizing radiation.
Area of Science:
- Medical Physics
- Biomedical Engineering
- Radiation Oncology
Background:
- Implantable cardiac devices like pacemakers and implantable cardioverter defibrillators (ICDs) are essential for managing cardiac arrhythmias.
- Patients with these devices may require radiation therapy, necessitating an understanding of device response to ionizing radiation.
Purpose of the Study:
- To evaluate the impact of 6-MV photon and 18-MeV electron radiation on the functionality of multiprogrammable pacemakers and ICDs.
- To determine the radiation tolerance of devices with different integrated circuit (IC) technologies, specifically complementary metal-oxide semiconductor (CMOS) and CMOS/Bipolar.
Main Methods:
- Twenty-three pacemakers and four ICDs with varying IC technologies (CMOS, CMOS/Bipolar) were subjected to controlled radiation exposure (6-MV photons, 18-MeV electrons).
- Device performance, including failure rates, charging times, sensitivity, and output energy, was monitored at different radiation dose levels.
Main Results:
- Pacemaker failures occurred at varying doses, with some failing before 50 Gy (photons) and 70 Gy (electrons).
- ICDs showed increased detection and charging times with accumulated dose, with catastrophic failure in charging noted below 50 total pulses.
- Devices utilizing shorter channel length (3 microns) CMOS IC technology exhibited significantly higher radiation tolerance, with no failures below 76 Gy.
Conclusions:
- Pacemaker and ICD functionality can be compromised by ionizing radiation, with failure modes dependent on radiation type and dose.
- Integrated circuit technology, particularly channel length, is a critical factor in determining radiation hardness.
- Shorter channel length CMOS technology offers enhanced radiation tolerance, potentially allowing for safer co-administration of radiation therapy and cardiac device implantation.