Safety of Computed Tomography in Patients With Cardiac Rhythm Management Devices

Abstract

The findings suggest that the presence of CRM devices should not delay or result in cancellation of clinically indicated CT imaging procedures, and provide evidence that would be helpful when the FDA advisory is re-evaluated.

Management of radiotherapy patients with implanted cardiac pacemakers and defibrillators: A Report of the AAPM TG‐203†

“…Brief CT examinations have been found to be safe for patients with CIEDs. The study by Hussein et al 74 showed no strong evidence of clinical significant risks associated with direct CT irradiation of CIEDs. However, precautions may need to be taken for scans that will directly irradiate the device for longer than 3 s (e.g., 4DCT scans or perfusion imaging).…”

“…Caution may be warranted when performing prolonged scans such as perfusion imaging or 4DCT to manage risk to the device. However, CT irradiation of a CIED has not shown to be a clinically significant problem . For positron emission tomography with 2‐deoxy‐2‐[fluorine‐18] fluoro‐D‐glucose integrated with CT (18F‐FDG PET/CT) scans, patients with a CIED can safely undergo the PET scan.…”

“…However, CT irradiation of a CIED has not shown to be a clinically significant problem. 74 For positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with CT (18F-FDG PET/CT) scans, patients with a CIED can safely undergo the PET scan. However, patients should inform the technologist about the presence of the CIED at the time of the scan.…”

Radiotherapy of patients with implantable electronical devices

“…4D CT). Bylo popsáno několik poruch v souvislosti s provozem CT, nicméně jen v případě dlouhodobějšího přímého ozáření těla přístroje s následkem nadměrné stimulace ICP a s vynecháním potřebné stimulace, případně se spouštěním antitachyarytmické léčby u ICD [27,34,35]. Krátkodobé ozáření přístroje nízkonapěťovými zdroji (v řádu keV) nejsou pro klinickou manifestaci přechodných poruch přístroje rizikové [36].…”