Radiotherapy in Patients with Cardiac Implantable Devices: A Single-Centre Retrospective Observational Analysis of...

Area of Science:

• Cardiology
• Oncology
• Medical Devices

Background:

• Increasing use of radiotherapy alongside cardiac implantable electronic devices (CIEDs) necessitates clear management guidelines.
• Ambiguity exists between international and manufacturer guidelines for managing CIED patients during radiotherapy.
• The British Heart Rhythm Society released new guidance in 2025, highlighting the need for safety data.

Purpose of the Study:

• To evaluate the safety and efficacy of a locally implemented Standard of Practice (SOP) for patients with CIEDs undergoing radiotherapy.
• To assess potential impacts of radiotherapy on CIED function and lead integrity.
• To compare the safety of the local SOP against existing international guidelines.

Main Methods:

• Retrospective, single-centre observational study of 320 patients with CIEDs receiving radiotherapy.
• Patients categorized into non-pacemaker-dependent, pacemaker-dependent, and implantable-cardioverter-defibrillator (ICD) groups.
• Lead sensing and impedance values analyzed pre- and post-radiotherapy using paired Student's T-test.

Main Results:

• No statistically significant changes in lead sensing capabilities across all patient groups (p > 0.05).
• No significant changes in lead impedance for ICD and non-pacemaker-dependent groups.
• A statistically significant but not clinically significant reduction in atrial lead impedance was noted in the pacemaker-dependent cohort (p = 0.039).

Conclusions:

• The locally implemented Standard of Practice (SOP) for radiotherapy in CIED patients is safe.
• The SOP demonstrates comparable safety to existing British Heart Rhythm Society guidelines.
• Findings support the adoption of the local SOP as a safe management strategy.