Radiotherapy-induced pacemaker and implantable cardioverter defibrillator malfunction.

It is well known that ionizing radiation can interfere with circuits in permanent pacemakers and implantable cardioverter defibrillators. Contemporary implantable cardiac devices use complementary metal-oxide silicon in combination with other very sensitive transistors. These sensitive components are especially susceptible to electromagnetic and ionizing radiation, which can potentially cause permanent damage. Electromagnetic interference is, in general, a transient phenomenon. Radiologic imaging tests have been implicated in rare cases of implantable device dysfunction and these events have been mostly transient. The American Association of Physicists in Medicine last published recommendations regarding irradiation of pacemakers in 1994. This publication is outdated and may not be pertinent for the current technology used both in the field of artificial cardiac pacing and defibrillation and in the field of radiation oncology. Updated guidelines are definitely needed.