title: Effect of radiation therapy on permanent pacemaker and implantable cardioverter-defibrillator function.
abstract: BACKGROUND
  Radiation therapy's (RT's) effects on cardiac implantable electronic devices (CIEDs) such as implantable cardioverter-defibrillators (ICDs) and pacemakers (PMs) are not well established, leading to device removal or relocation in preparation for RT.
  
  
  OBJECTIVE
  To determine the effect of scattered RT on CIED performance.
  
  
  METHODS
  We analyzed 69 patients--50 (72%) with PMs and 19 (28%) with ICDs--receiving RT at the University of Michigan. Collected data included device model, anatomic location, and treatment beam energies, treatment type, and estimated dose to the device. Patients were treated with either high-energy (16-MV) and/or low-energy (6 MV) photon beams with or without electron beams (6-16 MeV). The devices were interrogated with pre- and post-RT and/or weekly with either in-treatment or home interrogation, depending on the patient's dependence on the device and the estimated or measured delivered dose. Outcomes analyzed were inappropriate ICD therapies, device malfunctions, or device-related clinical events.
  
  
  RESULTS
  The PMs were exposed to 84.4 ± 99.7 cGy of radiation, and the ICDs were exposed to 92.1 ± 72.6 cGy of radiation. Two patients with ICDs experienced a partial reset of the ICD with the loss of historic diagnostic data after receiving 123 and 4 cGy, respectively. No device malfunction or premature battery depletion was observed at 6-month follow-up from RT completion.
  
  
  CONCLUSIONS
  CIED malfunction due to indirect RT exposure is uncommon. Regular in-treatment or home interrogation should be done to detect and treat these events and to ensure that diagnostic data are preserved.
authors.affiliation: Department of Cardiac Electrophysiology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Akash
authors.initials: A
authors.lastname: Makkar
authors.forename: Joann
authors.initials: J
authors.lastname: Prisciandaro
authors.forename: Sunil
authors.initials: S
authors.lastname: Agarwal
authors.forename: Morgan
authors.initials: M
authors.lastname: Lusk
authors.forename: Laura
authors.initials: L
authors.lastname: Horwood
authors.forename: Jean
authors.initials: J
authors.lastname: Moran
authors.forename: Colleen
authors.initials: C
authors.lastname: Fox
authors.forename: James A
authors.initials: JA
authors.lastname: Hayman
authors.forename: Hamid
authors.initials: H
authors.lastname: Ghanbari
authors.forename: Brett
authors.initials: B
authors.lastname: Roberts
authors.forename: Diego
authors.initials: D
authors.lastname: Belardi
authors.forename: Rakesh
authors.initials: R
authors.lastname: Latchamsetty
authors.forename: Thomas
authors.initials: T
authors.lastname: Crawford
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.forename: Krit
authors.initials: K
authors.lastname: Jongnarangsin
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000628:therapy*; D017147:Defibrillators, Implantable; D004868:Equipment Failure; D019544:Equipment Failure Analysis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000532:radiotherapy*; D010138:Pacemaker, Artificial; D011839:Radiation, Ionizing; D011879:Radiotherapy Dosage; D012189:Retrospective Studies