Radiotherapy in Patients With a Cardiac Implantable Electronic Device

Sharifzadehgan, Ardalan; Laurans, M.; Thuillot, M.; Huertas, Alice; Baudinaud, Pierre; Narayanan, Kumar; Mirabel, Mariana; Bibault, Jean‐Emmanuel; Frey, Pierre; Waldmann, Victor; Varlet, Emilie; Amet, Denis; Juin, Christophe; Lavergne, Thomas; Jouven, Xavier; Giraud, P.; Durdux, C.; Marijon, Éloi

doi:10.1016/j.amjcard.2020.04.045

Cited by 15 publications

(20 citation statements)

References 26 publications

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“…The CIED dysfunction rate in our study was more than double that reported in other recent retrospective clinical studies, 1,6–13 which have reported device dysfunction rates of 2%–7%. However, it is lower than that in a smaller, older study published by Elders et al, 18 which reported that dysfunctions occurred in 5/17 (29.4%) radiation treatments in a population of 15 ICD patients.…”

Section: Discussionsupporting

confidence: 56%

“…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%

“…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%) 1,6–13 . Overall, our incidence was approximately one dysfunction per 100 RT sessions.…”

Section: Discussionmentioning

confidence: 70%

“…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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Section: Discussionsupporting

confidence: 56%

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…The main issue for patients with CIEDs during surgery is EMI, which is most commonly caused by monopolar electrosurgery [10][11][12][13]. Bipolar electrosurgery [14], radiation therapy [15][16][17][18][19] and radiofrequency ablation [20][21][22] may also occasionally cause EMIinduced CIED malfunctions.…”

Section: What Could Go Wrong?mentioning

confidence: 99%

Perioperative Management of Patients with Cardiac Implantable Electronic Devices and Utility of Magnet Application

Özkartal

Demarchi

Caputo

et al. 2022

JCM

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With the demographic evolution of the population, patients undergoing surgery today are older and have an increasing number of sometimes complex comorbidities. Cardiac implantable electronic devices (CIED) are also getting more and more complex with very sophisticated programming algorithms. It may be generally assumed that magnet application reverts pacing to an asynchronous mode in pacemakers and disables tachycardia detection/therapy in internal cardioverter-defibrillators. However, depending on device type, manufacturer and model, the response to magnet application may differ substantially. For these reasons, perioperative management of CIED patients is getting more and more challenging. With this review article we provide an overview of optimal perioperative management of CIED patients with a detailed description of CIED response to magnet application depending on manufacturer and device-type, which may help in providing a safe perioperative management plan for the CIED patient.

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Radiotherapy for patient with cardiac implantable electronic device, consensus from French radiation oncology society

Escande

Frey

Lacornerie

et al. 2022

Cancer/Radiothérapie

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Radiotherapy in Patients With a Cardiac Implantable Electronic Device

Cited by 15 publications

References 26 publications

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

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

Perioperative Management of Patients with Cardiac Implantable Electronic Devices and Utility of Magnet Application

Radiotherapy for patient with cardiac implantable electronic device, consensus from French radiation oncology society

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