Radiation Therapy-Induced Dysfunction in Cardiovascular Implantable Electronic Devices.

Area of Science:

• Oncology
• Cardiology
• Medical Physics

Background:

• Increasing number of cancer patients have cardiovascular implantable electronic devices (CIEDs).
• External beam radiation therapy (RT) poses a risk to CIED electronic components.
• The incidence and predictors of CIED dysfunction during RT require evaluation.

Purpose of the Study:

• To assess the incidence of new-onset CIED dysfunction in cancer patients undergoing RT.
• To identify predictors of CIED malfunction in patients receiving radiation treatment.

Main Methods:

• Retrospective analysis of 230 patients with CIEDs treated with RT (February 2007-November 2013).
• Evaluation of CIED parameters before, during, and after RT.
• Analysis included various RT modalities: linear accelerators, orthovoltage machines, and brachytherapy.

Main Results:

• 18 events (7.8%) of CIED dysfunction occurred in 16 patients.
• Most events (16/18) were associated with neutron-producing RT.
• Higher radiation doses (prescription and estimated at CIED) correlated with increased malfunction probability.

Conclusions:

• CIED malfunctions during RT are infrequent and generally not life-threatening.
• Limiting radiation dose to the CIED is recommended.
• Avoiding neutron-producing RT may reduce the risk of CIED malfunction.