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Life-threatening pacemaker dysfunction associated with therapeutic radiation: a case report
Andreas Zweng1, Reinhard Schuster, Robert Hawlicek
11st Medical Department, SMZO-Danube Hospital, Langobardenstrasse 122, Vienna 1220, Austria. andreas.zweng@wienkav.at
Angiology
|April 5, 2008
Summary
Pacemaker (PM) malfunction, specifically a runaway PM, occurred during radiation therapy in a patient with esophageal cancer. This rare event, likely caused by electromagnetic interference (EMI) rather than radiation, highlights potential risks during cancer treatment.
Area of Science:
- Medical Physics
- Oncology
- Cardiology
Background:
- Pacemaker (PM) devices possess robust shielding against electromagnetic interference (EMI).
- Reports of PM dysfunction during irradiation (IR) are exceptionally rare due to these protective measures.
Observation:
- A 76-year-old woman with inoperable esophageal cancer experienced a runaway PM during a course of photon IR.
- The estimated in vivo radiation dose was 0.11 Gy, the lowest reported to date.
Findings:
- Direct radiation effects on the PM are improbable at such a low dose.
- The PM dysfunction was most likely induced by EMI generated during radiotherapy.
- The precise cause of the device's software failure remains undetermined.
Implications:
- This case underscores the potential for rare pacemaker malfunctions during cancer radiotherapy.
- Further investigation is needed to understand the specific mechanisms of EMI-induced PM dysfunction.
- Ensuring patient safety requires awareness of potential device interactions during radiation treatment.
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