Effects of scatter radiation on ICD and CRT function

Suraj Kapa, Luis Fong, Charles R. Blackwell, Michael G. Herman, Paula J. Schomberg, David L. Hayes

Research output: Contribution to journalReview article

42 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)727-732
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume31
Issue number6
DOIs
StatePublished - Jun 1 2008

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Cardiac Resynchronization Therapy
Implantable Defibrillators
Radiation Effects
Radiation
Equipment and Supplies
Radiotherapy
Photons

Keywords

  • Cardiac resynchronization therapy
  • Defibrillation-implantable cardioverter-defibrillator
  • Radiation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kapa, S., Fong, L., Blackwell, C. R., Herman, M. G., Schomberg, P. J., & Hayes, D. L. (2008). Effects of scatter radiation on ICD and CRT function. PACE - Pacing and Clinical Electrophysiology, 31(6), 727-732. https://doi.org/10.1111/j.1540-8159.2008.01077.x

Effects of scatter radiation on ICD and CRT function. / Kapa, Suraj; Fong, Luis; Blackwell, Charles R.; Herman, Michael G.; Schomberg, Paula J.; Hayes, David L.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 31, No. 6, 01.06.2008, p. 727-732.

Research output: Contribution to journalReview article

Kapa, S, Fong, L, Blackwell, CR, Herman, MG, Schomberg, PJ & Hayes, DL 2008, 'Effects of scatter radiation on ICD and CRT function', PACE - Pacing and Clinical Electrophysiology, vol. 31, no. 6, pp. 727-732. https://doi.org/10.1111/j.1540-8159.2008.01077.x
Kapa, Suraj ; Fong, Luis ; Blackwell, Charles R. ; Herman, Michael G. ; Schomberg, Paula J. ; Hayes, David L. / Effects of scatter radiation on ICD and CRT function. In: PACE - Pacing and Clinical Electrophysiology. 2008 ; Vol. 31, No. 6. pp. 727-732.
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AB - 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.

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