Premium
Effects of Scatter Radiation on ICD and CRT Function
Author(s) -
KAPA SURAJ,
FONG LUIS,
BLACKWELL CHARLES R,
HERMAN MICHAEL G.,
SCHOMBERG PAULA J,
HAYES DAVID L
Publication year - 2008
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2008.01077.x
Subject(s) - medicine , radiation therapy , cardiac resynchronization therapy , implantable cardioverter defibrillator , reset (finance) , medical physics , radiology , nuclear medicine , cardiology , ejection fraction , heart failure , economics , financial economics
Background: Effects of direct radiation on implantable cardiac devices have been well studied. However, the effects of scatter radiation are not as clear. Recommendations on management of patients with implantable cardiac devices undergoing radiotherapy are based on limited studies mostly involving pacemakers. We sought to elucidate the effects of scatter radiation on implantable cardioverter‐defibrillators (ICDs) and cardiac resynchronization therapy (CRT)‐ICDs.Methods: We exposed 12 ICDs and eight CRT‐ICDs to 400 cGy of scatter radiation from a 6‐MV photon beam. Devices were programmed with nominal parameters and interrogated prior to radiation, after each fraction, upon completion of the radiation course and again 1 week later. A retrospective review of patients undergoing radiotherapy at the Mayo Clinic–Rochester between 2002 and 2007 in whom the device was outside the radiation field was also performed. There were 13 patients with devices undergoing radiotherapy during this time period, 12 of whom were interrogated prior to and after radiation.Results: Interrogation reports were reviewed for device reset or parameter changes. There was no evidence of reset or malfunction during or after radiation. Also, no episodes of device reset, inappropriate sensing or therapy, or changes in programmed parameters were found in our review of patients undergoing radiotherapy.Conclusions: Device reset or malfunction associated with scatter radiation likely represents an unpredictable, rare occurrence. While we see no clear contraindication to radiotherapy in patients with ICDs or CRT‐ICDs, precautions should be taken to avoid direct radiation exposure and to closely evaluate patient outcomes before and after the radiation course.