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2017 | 7 | 2 | 64-69
Article title

Radiotherapy in patients with cardiac implantable electronic devices – clinical experience

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The number of patients with cardiac implantable electronic devices (CIEDs) constantly increases and due to growing incidence of cancer, many of them will require an anticancer treatment. At least a half of patients treated for malignant neoplasms, apart from other treatment methods, require radiotherapy. Although papers presenting the results of in vitro studies provide clues on the susceptibility of CIEDs to ionizing radiation, the research methods used often stand out from typical clinical situations. Direct irradiation of the devices is avoided and the doses delivered to pulse generators are far below those seen in the in vitro studies. In this review the most important clinical observations made during irradiation of patients with CIEDs are summarized and practical directions for physicians and physicists involved in radiation treatment planning and delivery are given.
Physical description
  • 1. Raatikainen MJP, Arnar DO, Zeppenfeld K et al. Statistics on the Use of Cardiac Electronic Devices and Electrophysiological Procedures in the European Society of Cardiology Countries: 2014 Report from the European Heart Rhythm Association. Europace 2015; 17(Suppl. 1): i1-75.
  • 2. Global Burden of Disease Cancer Collaboration; Fitzmaurice C, Allen C et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2016; 388: 1459-1544.
  • 3. Reynolds D, Duray GZ, Omar R et al. A Leadless Intracardiac Transcatheter Pacing System. N Engl J Med 2016; 374: 533-541.
  • 4. Steffel J. The Subcutaneous Implantable Cardioverter Defibrillator. Eur Heart J 2017; 38: 226-228.
  • 5. Brignole M, Auricchio A, Baron-Esquivias G et al. 2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy: The Task Force on Cardiac Pacing and Resynchronization Therapy of the European Society of Cardiology (ESC). Developed in Collaboration with the European Heart Rhythm Association. Eur Heart J 2013; 34: 2281-2329.
  • 6. Blamek S, Gabryś D, Kulik R et al. Stereotactic Body Radiosurgery, Robotic Radiosurgery and Tomotherapy in Patients with Pacemakers and Implantable Cardioverters-Defibrillators: Mini-Review. Exp Clin Cardiol 2014; 20: 757-763.
  • 7. Grant JD, Jensen GL, Tang C et al. Radiotherapy-Induced Malfunction in Contemporary Cardiovascular Implantable Electronic Devices. JAMA Oncol 2015; 1: 624-632.
  • 8. Bagur R, Chamula M, Brouillard É et al. Radiotherapy-Induced Cardiac Implantable Electronic Device Dysfunction in Patients with Cancer. Am J Cardiol 2017; 119: 284-289.
  • 9. Elders J, Kunze-Busch M, Jan Smeenk R et al. High Incidence of Implantable Cardioverter Defibrillator Malfunctions During Radiation Therapy: Neutrons as a Probable Cause of Soft Errors. Europace 2013; 15: 60–65.
  • 10. Augustynek M, Korpas D, Penhaker M et al. Monitoring of CRT-D Devices During Radiation Therapy in Vitro. Biomed Eng Online 2016; 15: 29.
  • 11. Gauter-Fleckenstein B, Israel CW, Dorenkamp M et al. DEGRO/DGK Guideline for Radiotherapy in Patients with Cardiac Implantable Electronic Devices. Strahlenther Onkol 2015; 191: 393-404.
  • 12. Lester J, Evans L, Mayles P et al. Management of Cancer Patients Receiving Radiotherapy with a Cardiac Implanted Electronic Device: A Clinical Guideline. [online: electronic-device-clinical].
  • 13. Hurkmans CW, Knegjens JL, Oei BS et al. Management of Radiation Oncology Patients with A Pacemaker or ICD: A New Comprehensive Practical Guideline in The Netherlands. Dutch Society of Radiotherapy and Oncology (NVRO). Radiat Oncol 2012; 7: 198.
  • 14. Lambert P, Da Costa A, Marcy PY et al. Pacemaker, défibrillateur et radiothérapie: propositions de conduite à tenir en 2010 en fonction du type de stimulateur cardiaque, du pronostic et du site du cancer. Cancer/Radiotherapie 2011; 15: 238-249.
  • 15. Brambatti M, Mathew R, Strang B et al. Management of Patients with Implantable Cardioverter-Defibrillators and Pacemakers who Require Radiation Therapy. Heart Rhythm 2015; 12: 2148-2154.
  • 16. Makkar A, Prisciandaro J, Agarwal S et al. Effect of Radiation Therapy on Permanent Pacemaker and Implantable Cardioverter-Defibrillator Function. Heart Rhythm 2012; 9: 1964-1968.
  • 17. Gelblum DY, Amols H. Implanted Cardiac Defibrillator Care in Radiation Oncology Patient Population. Int J Radiat Oncol Biol Phys 2009; 73: 1525- 1531.
  • 18. Gomez DR, Poenisch F, Pinnix CC et al. Malfunctions of Implantable Cardiac Devices in Patients Receiving Proton Beam Therapy: Incidence and Predictors. Int J Radiat Oncol Biol Phys 2013; 87: 570-575.
  • 19. Nemec J. Runaway Implantable Defibrillator – A Rare Complication of Radiation Therapy. Pacing Clin Electrophysiol 2007; 30 :716-718.
  • 20. Maisel WH, Moynahan M, Zuckerman BD et al. Pacemaker and ICD Generator Malfunctions: Analysis of Food and Drug Administration Annual Reports. JAMA 2006; 295: 1901-1906.
  • 21. Hauser RG, Hayes DL, Epstein AE et al. Multicenter Experience with Failed and Recalled Implantable Cardioverter-Defibrillator Pulse Generators. Heart Rhythm 2006; 3: 640-644.
  • 22. Tajstra M, Gadula-Gacek E, Buchta P et al. Effect of Therapeutic Ionizing Radiation on Implantable Electronic Devices: Systematic Review and Practical Guidance. J Cardiovasc Electrophysiol 2016; 27(10): 1247-1251. DOI: 10.1111/jce.13034.
  • 23. Marbach JR, Sontag MR, Van Dyk J et al. Management of Radiation Oncology Patients with Implanted Cardiac Pacemakers Management of Radiation Oncology Patients with Implanted Cardiac Pacemakers. Med Phys 1994; 21: 82-90.
  • 24. Frizzell B. Radiation therapy in oncology patients who have a pacemaker or implantable cardioverter-defibrillator. Community Oncol 2009; 6: 469-471.
  • 25. Niehaus M, Tebbenjohanns J. Electromagnetic interference in patients with implanted pacemakers or cardioverter-defibrillators. Heart 2001; 86: 246-248.
  • 26. PTRO. Wytyczne leczenia promieniami jonizującymi pacjentów z układem stymulującym serce (2015) [online: rozrusznik.pdf.
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