AIMS: To investigate the behaviour of the implantable cardioverter defibrillator (ICD) function during actual radiotherapy sessions. METHODS AND RESULTS: Fifteen patients with an ICD underwent 17 radiation treatments for cancer [cumulative dose to the tumour was between 16 Gray (Gy) and 70 Gy; photon beams with maximum energies between 6 megaelectronvolt (MeV) and 18 MeV were employed]. During every session, the ICD was programmed to a monitoring mode to prevent inappropriate therapy delivery. Afterwards, the ICDs were interrogated to ensure proper function. Calculated radiation dose at the ICD site was <1 Gy in all patients. In 5 out of 17 radiation treatments (29%) the ICDs showed 6 malfunctions (35%). We noticed four disturbances in the memory data or device resets during radiation treatment and one case of inappropriate ventricular fibrillation detection due to external noise. In one case a late device data error was observed. All malfunctions occurred at 10 and 18 MeV beam energies. CONCLUSION: Despite the fact that all recommended precautions were taken to minimize the damage to the ICDs during radiotherapy and the calculated dose to the ICDs was <1 Gy, in 29% of the treatments a malfunction occurred. We observed a possible correlation between the beam energy and the malfunctions. This correlation may be due to an interaction between neutrons produced in the head of the linear accelerator at beam energies ≥10 MeV, and boron-10 which is present in the integrated circuit.
AIMS: To investigate the behaviour of the implantable cardioverter defibrillator (ICD) function during actual radiotherapy sessions. METHODS AND RESULTS: Fifteen patients with an ICD underwent 17 radiation treatments for cancer [cumulative dose to the tumour was between 16 Gray (Gy) and 70 Gy; photon beams with maximum energies between 6 megaelectronvolt (MeV) and 18 MeV were employed]. During every session, the ICD was programmed to a monitoring mode to prevent inappropriate therapy delivery. Afterwards, the ICDs were interrogated to ensure proper function. Calculated radiation dose at the ICD site was <1 Gy in all patients. In 5 out of 17 radiation treatments (29%) the ICDs showed 6 malfunctions (35%). We noticed four disturbances in the memory data or device resets during radiation treatment and one case of inappropriate ventricular fibrillation detection due to external noise. In one case a late device data error was observed. All malfunctions occurred at 10 and 18 MeV beam energies. CONCLUSION: Despite the fact that all recommended precautions were taken to minimize the damage to the ICDs during radiotherapy and the calculated dose to the ICDs was <1 Gy, in 29% of the treatments a malfunction occurred. We observed a possible correlation between the beam energy and the malfunctions. This correlation may be due to an interaction between neutrons produced in the head of the linear accelerator at beam energies ≥10 MeV, and boron-10 which is present in the integrated circuit.
Authors: Michael Mollerus; Leslee Naslund; Margaret Lipinski; Anne Meyer; Bruce Libey; Ken Dornfeld Journal: J Interv Card Electrophysiol Date: 2013-12-07 Impact factor: 1.900
Authors: Vincenzo L Malavasi; Giuseppina De Marco; Jacopo F Imberti; Filippo Placentino; Marco Vitolo; Ercole Mazzeo; Gianfranco Cicoria; Edoardo Casali; Vincenzo Turco; Frank Lohr; Giuseppe Boriani Journal: Intern Emerg Med Date: 2019-12-02 Impact factor: 3.397
Authors: Daniel R Gomez; Falk Poenisch; Chelsea C Pinnix; Tommy Sheu; Joe Y Chang; Nada Memon; Radhe Mohan; Marc A Rozner; Anne H Dougherty Journal: Int J Radiat Oncol Biol Phys Date: 2013-11-01 Impact factor: 7.038