Pacemaker Relocation for Radiation Against Overlapping Lung Cancer

Area of Science:

• Cardiology
• Oncology
• Medical Devices

Background:

• Pacemaker (PM) implantation is common in elderly patients, some of whom may develop thoracic malignancies.
• Radiation therapy is a primary treatment for lung cancer, but can be complicated by the presence of implanted electronic devices like PMs.

Observation:

• An 81-year-old male patient with a PM developed left upper lobe lung cancer adjacent to the device.
• Radiation therapy was indicated, necessitating PM repositioning to prevent direct radiation damage.

Findings:

• The PM was relocated to the abdomen, and an epicardial pacing lead was placed on the right ventricle.
• The patient received 62 Gy of radiotherapy for lung cancer, achieving temporary tumor shrinkage.
• The repositioned PM functioned normally throughout the radiation therapy course without adverse events.

Implications:

• PM relocation surgery using epicardial leads is a feasible strategy for managing patients with overlapping lung tumors and PMs requiring radiotherapy.
• This approach allows for effective cancer treatment while ensuring the continued safe function of cardiac pacing devices.