Therapeutic irradiation over a permanent cardiac pacemaker.
Therapeutic irradiation of fields containing cardiac pacemakers presents a unique problem to pacemaker physicians and radiation oncologists alike. The present case involved a proposed radiation field containing both subclavian pockets. As an alternative solution, the Cordis model 334A implantable pulse generator was irradiated using a backup temporary pacemaker that was kept outside of any significant radiation exposure. A total of 60 Gy was delivered in 30 fractions, with backup temporary pacing and continuous ECG monitoring used for the first 5 fractions. Frequent re-evaluation of pacing and sensing function revealed no changes as a result of irradiation; following radiotherapy, transtelephonic monitoring showed normal pacemaker function for a 4 month follow-up. This represents a useful alternative, particularly for nonmultiprogrammable pacemakers that are made of more radiation-resistant technology.
Teskey
R J
RJ
University of Ottawa Heart Institute, Ontario, Canada.
Whelan
I
I
Akyurekli
Y
Y
Eapen
L
L
Green
M S
MS
D000368:Aged; D002277:Carcinoma / Q000532:radiotherapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D010138:Pacemaker, Artificial