Radiotherapy-Induced Cardiac Implantable Electronic Device Dysfunction in Patients With Cancer

CIED malfunction in patients receiving radiation is a rare event that could be detected by remote monitoring

“…15 These studies report an incidence of RT attributable CIED abnormalities ranging from 1.5% to 7% 10,16,17 with the most commonly identified CIED mal- show that CIED malfunction is a rare event and that many of the events seen in our series, as well as those reported in other series, can be monitored and detected through contemporary remote CIED monitoring systems. 15 These studies report an incidence of RT attributable CIED abnormalities ranging from 1.5% to 7% 10,16,17 with the most commonly identified CIED mal- show that CIED malfunction is a rare event and that many of the events seen in our series, as well as those reported in other series, can be monitored and detected through contemporary remote CIED monitoring systems.…”

“…In comparison, the literature reports on a variety of radiation related CIED malfunctions, which includes such events as inappropriate sensing due to noise, 5 runaway pacemaker resulting in rapid inappropriate pacing, 9 reset to back-up pacing resulting in AV dyssynchrony, 10 inappropriate ICD shocks due to noise, 11 and complete device failure. Furthermore, 20% of the patients had prior ventricular arrhythmias with ICDs being placed for secondary prevention.…”

Revisiting the impact of radiation therapy on cardiac implantable electronic device (CIED) function

“…3,4,[7][8][9][10][11] RT can cause CIED malfunction from either destruction of electrical components or due to effects on CIEDs' random access memory. The use of CT imaging for 3D localization of tumor bulk and adjacent critical structures along with intensity modulation, allowing focused radiation on tumor bulk and minimizing surrounding exposure, have dramatically increased the efficacy/safety ratio of RT.…”

“…The use of CT imaging for 3D localization of tumor bulk and adjacent critical structures along with intensity modulation, allowing focused radiation on tumor bulk and minimizing surrounding exposure, have dramatically increased the efficacy/safety ratio of RT. 3,4,[7][8][9][10][11] RT can cause CIED malfunction from either destruction of electrical components or due to effects on CIEDs' random access memory. [3][4][5][6] As of today, various CIED malfunctions have been associated with RT ranging from loss of historical diagnostic data stored in the devices, device reprogramming, inappropriate triggering or inhibition of device therapies, and complete device failure.…”

“…3,4,[7][8][9][10][11] RT can cause CIED malfunction from either destruction of electrical components or due to effects on CIEDs' random access memory. 1 The authors have thoroughly evaluated various irradiation parameters that might have had an impact of CIED function, including: RT type (photon / electron beam), energy, sequence, dose and fractionation, RT site (ie, the radiation target area), and its distance from the CIED with calculated estimation of the radiation dose delivered to the CIED.…”