Evaluation of cardiac implantable electronic device lead parameters before and after radiotherapy

• Published in: Pacing and clinical electrophysiology Vol. 47; no. 9; pp. 1176 - 1184
• Main Authors: Larsen, Mia Bang, Jakobsen, Annette Ross, Lundbye‐Christensen, Søren, Riahi, Sam, Thøgersen, Anna Margrethe, Zaremba, Tomas
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-09-2024
• Subjects: beam energy; Defibrillators; device malfunctions; implantable cardioverter defibrillator; ionizing radiation; Medical records; Pacemaker; Pacemakers; Patients; Radiation therapy; radiotherapy; radiotherapy; implantable cardioverter defibrillator; device malfunctions; beam energy; Pacemaker; ionizing radiation
• ISSN: 0147-8389; 1540-8159; 1540-8159
• DOI: 10.1111/pace.15048

Introduction and aim
Radiotherapy in cancer patients with a pacemaker or an implantable cardioverter defibrillator might damage the device and possibly result in malfunction of the device. We aimed to examine device malfunction and change in lead parameters in this group.
Methods
The medical records of pacemaker/implantable cardioverter defibrillator patients who underwent radiotherapy at Aalborg University Hospital between July 1, 2016, and June 30, 2021, were reviewed. Treatment was planned according to risk of device malfunction, assessed using local guidelines. Bootstrap linear regression was used to identify possible differences in lead parameters depending on beam energy and anatomical location.
Results
One hundred nine patients with a pacemaker/implantable cardioverter defibrillator who received a total of 122 radiotherapy courses in the study period were identified. No device malfunctions or significant changes in lead parameters during radiotherapy were observed. Only the left ventricle lead threshold and impedance were found to be significantly different when compared by beam energy; however, these changes were relatively small and unlikely to be of clinical relevance.
Conclusion
No device malfunction or clinically relevant changes in lead parameters were identified in this study, suggesting that radiotherapy of pacemaker/implantable cardioverter defibrillator patients can be regarded as safe when following relevant safety precautions.