Radiation Therapy–Induced Dysfunction in Cardiovascular Implantable Electronic Devices

Brouillard, E.; Chamula, Mathilde; Lavoie, Caroline; Varfalvy, Nicolas; Archambault, Louis

doi:10.1016/j.prro.2019.03.003

Cited by 13 publications

(29 citation statements)

References 28 publications

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“…To our knowledge, this is largest published series investigating CIED malfunctions in patients receiving RT. The 4% incidence of CIED malfunction and lack of association between radiation dose and malfunction are consistent with prior reported studies 10,15,[23][24][25][26] .…”

Section: Discussionsupporting

confidence: 91%

“…The 4% incidence of CIED malfunction and the lack of association between radiation dose and malfunction are consistent with results of prior reported studies. 10 , 15 , 23 , 24 , 25 , 26 The results of this study suggest that CIED malfunctions are uncommon in centres that follow an algorithm of risk assessment for device management post–radiation therapy. Furthermore, our results support the recent studies and expert consensus statements that have compellingly indicated that neutron-producing radiation and the associated beam energy are the strongest predictors of CIED malfunction.…”

Section: Discussionmentioning

confidence: 73%

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Assessment of Radiation-Induced Malfunction in Cardiac Implantable Electronic Devices

et al. 2021

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 73%

Assessment of Radiation-Induced Malfunction in Cardiac Implantable Electronic Devices

et al. 2021

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“…In this contemporary, single-center, prospective study, which included all consecutive patients with a CIED who underwent RT over a 7-year period, CIED dysfunctions were more frequent (14.1% of courses) than previously described (2%-7%). The CIED dysfunction rate in our study was more than double that reported in other recent retrospective clinical studies, 1,[6][7][8][9][10][11][12][13] which have reported device dysfunction rates of 2%-7%.…”

Section: Discussionsupporting

confidence: 55%

“…the CIED were significantly associated with the probability of CIED dysfunction (p = .0006 and p = .003, respectively); and no events occurred for prescribed doses <30 Gy. 12 Our study shows a relationship between cumulative tumor dose and CIED dysfunction with a weaker-but statistically significant-association compared to neutron-producing irradiation.…”

Section: Discussionmentioning

confidence: 50%

“…5 However, there are insufficient data to suggest that CIED leads are sensitive to RT effects. 5 According to available retrospective data, RT-related dysfunctions appear to affect 2%-7% of patients with CIEDs undergoing RT and are mostly benign, 1,[6][7][8][9][10][11][12][13][14] although exceptional cases of runaway PM have been described. 15,16 Proposed risk factors for CIED dysfunctions include neutron-producing irradiation, type of device (ICDs pose more risk than PMs), cumulative tumor dose, and CIED dose.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac implantable electronic device dysfunctions in patients undergoing radiotherapy: A prospective cohort study

Frey

Irles

Dompnier

et al. 2022

Cardiovasc electrophysiol

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Background: Increasing numbers of patients with cardiac implantable electronic devices (CIEDs) are undergoing radiotherapy (RT) for cancer. The aim of the study was to prospectively evaluate the incidence, characteristics, and associated factors of CIED dysfunctions related to RT.Methods: Between April 2013 and March 2020, all patients with a CIED who underwent ≥1 RT session were enrolled. Patients were monitored according to a systematic protocol, including device interrogation before the first and after each RT session. The primary endpoint was CIED dysfunction, defined as oversensing, total or partial deprogramming, and/or unrecoverable reset.Results: We included a total of 92 CIED RT courses: 77 (83.7%) in patients with a pacemaker and 15 (16.3%) in those with an implantable cardioverter-defibrillator.Overall, 13 dysfunctions (14.1%) were observed during 92 courses (1509 sessions), giving an incidence of 0.9 per 100 sessions. These included nine deprogramming (three total resets to back-up pacing mode and six partial deprogramming that were all successfully reprogrammed), three transient oversensing, and one unrecoverable oversensing requiring CIED and leads replacement. There were no adverse clinical events related to device dysfunction. In multivariable analysis, neutron-producing irradiation (odds ratio [OR], 5.59; 95% confidence interval [CI], 1.09-28.65; p = .039) and cumulative tumor dose (OR, 1.05; 95% CI, 1.01-1.10; p = .007) remained significantly associated with CIED dysfunction. Conclusion:In this prospective study, transient or permanent subclinical CIED dysfunction occurred in 14.1% of RT courses. Our findings emphasize the importance of high-energy beams and neutron-producing irradiation in risk assessment.

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Radiotherapy of patients with cardiac implantable electronic devices according to the DEGRO/DGK guideline—is the risk of relevant errors overestimated?

et al. 2019

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Radiation Therapy–Induced Dysfunction in Cardiovascular Implantable Electronic Devices

Cited by 13 publications

References 28 publications

Assessment of Radiation-Induced Malfunction in Cardiac Implantable Electronic Devices

Assessment of Radiation-Induced Malfunction in Cardiac Implantable Electronic Devices

Cardiac implantable electronic device dysfunctions in patients undergoing radiotherapy: A prospective cohort study

Radiotherapy of patients with cardiac implantable electronic devices according to the DEGRO/DGK guideline—is the risk of relevant errors overestimated?

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