P682Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices
Abstract Background The number of patients with cardiac implantable electronic devices (CIED) requiring a radiation therapy (RT) for cancer treatment is increasing over time. Nevertheless, the rate and predictors of CIED malfunctions are still controversial. Purpose The aim of our study is to estima...
Gespeichert in:
| Veröffentlicht in: | European heart journal 2019-10, Vol.40 (Supplement_1) |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | Supplement_1 |
| container_start_page | |
| container_title | European heart journal |
| container_volume | 40 |
| creator | Imberti, J F Placentino, F Malavasi, V L Demarco, G Lohr, F Boriani, G |
| description | Abstract
Background
The number of patients with cardiac implantable electronic devices (CIED) requiring a radiation therapy (RT) for cancer treatment is increasing over time. Nevertheless, the rate and predictors of CIED malfunctions are still controversial.
Purpose
The aim of our study is to estimate the prevalence and possible predictors of RT-related CIED malfunctions and to describe malfunction characteristics.
Methods
We retrospectively reviewed medical records of all pacemaker (PM)/implantable cardioverter defibrillator (ICD) patients who underwent RT at our centre between January 2004 and July 2018. We included data from the CIED interrogation performed before the RT course to the first interrogation after the end of the RT course. As a safety measure, during RT a magnet was applied to every ICD and, in all PM-dependent patients, the device was temporarily reprogrammed in V00. Device relocation from the RT field was performed in 2/150 (1.3%) RT courses.
Results
One hundred twenty-seven patients were included, who underwent 150 separate RT courses. Eighty one percent of patients had a PM, while 19% had an ICD. Of note 17.4% of patients were PM-dependent. Neutron producing RT was used in 37/139 (26.6%) patients, whereas marginal neutron producing and non-neutron producing RT was used in 9/139 (6.4%) and 93/139 (67%) patients respectively. The cumulative dose (Dmax) delivered to the CIED exceeded 5Gy only in 2/132 (1.5%) cases. Three device-related malfunctions were found (2%). None of them were life-threatening or lead to a clinical event. All dysfunctions were resolved by reprogramming the device and did not require CIED substitution or leads extraction. Details of dysfunctions included: 1) a partial reset of an ICD, leading to self-reprogramming in safety mode, 2) full reset of a PM, which required the re-initialisation of the device and 3) programming change of the magnetic PM frequency to 30bpm (instead of 90 bpm). In all cases the Dmax delivered to the CIED was |
| doi_str_mv | 10.1093/eurheartj/ehz747.0288 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_eurheartj_ehz747_0288</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/eurheartj/ehz747.0288</oup_id><sourcerecordid>10.1093/eurheartj/ehz747.0288</sourcerecordid><originalsourceid>FETCH-LOGICAL-c878-74b165bf48748c2d2bf66e5fb86404461d1f0e53ac424989c84155d208955e673</originalsourceid><addsrcrecordid>eNqN0N9KwzAUx_EgCs7pIwh5gW5JlqTppQz_gaDILrwr6ckJzejSkqbKfHo3Jl57deDA93fxIeSWswVn1WqJU2rRprxdYvtdynLBhDFnZMaVEEWlpTonM8YrVWhtPi7J1ThuGWNGcz0j8KaNeLcu9LnFZId9EaKbAB3d2c5PEXLoIw2Rgo2AiQ42B4x5pF8ht4dncsECDbuhszHbpkOKHUJOfQxAHX4GwPGaXHjbjXjze-dk83C_WT8VL6-Pz-u7lwJMaYpSNlyrxktTSgPCicZrjco3RksmpeaOe4ZqZUEKWZkKjORKOcFMpRTqcjUn6jQLqR_HhL4eUtjZtK85q49Q9R9UfYKqj1CHjp26fhr-mfwAvitx8A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>P682Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices</title><source>Electronic Journals Library</source><source>Oxford University Press Journals</source><source>Alma/SFX Local Collection</source><creator>Imberti, J F ; Placentino, F ; Malavasi, V L ; Demarco, G ; Lohr, F ; Boriani, G</creator><creatorcontrib>Imberti, J F ; Placentino, F ; Malavasi, V L ; Demarco, G ; Lohr, F ; Boriani, G</creatorcontrib><description>Abstract
Background
The number of patients with cardiac implantable electronic devices (CIED) requiring a radiation therapy (RT) for cancer treatment is increasing over time. Nevertheless, the rate and predictors of CIED malfunctions are still controversial.
Purpose
The aim of our study is to estimate the prevalence and possible predictors of RT-related CIED malfunctions and to describe malfunction characteristics.
Methods
We retrospectively reviewed medical records of all pacemaker (PM)/implantable cardioverter defibrillator (ICD) patients who underwent RT at our centre between January 2004 and July 2018. We included data from the CIED interrogation performed before the RT course to the first interrogation after the end of the RT course. As a safety measure, during RT a magnet was applied to every ICD and, in all PM-dependent patients, the device was temporarily reprogrammed in V00. Device relocation from the RT field was performed in 2/150 (1.3%) RT courses.
Results
One hundred twenty-seven patients were included, who underwent 150 separate RT courses. Eighty one percent of patients had a PM, while 19% had an ICD. Of note 17.4% of patients were PM-dependent. Neutron producing RT was used in 37/139 (26.6%) patients, whereas marginal neutron producing and non-neutron producing RT was used in 9/139 (6.4%) and 93/139 (67%) patients respectively. The cumulative dose (Dmax) delivered to the CIED exceeded 5Gy only in 2/132 (1.5%) cases. Three device-related malfunctions were found (2%). None of them were life-threatening or lead to a clinical event. All dysfunctions were resolved by reprogramming the device and did not require CIED substitution or leads extraction. Details of dysfunctions included: 1) a partial reset of an ICD, leading to self-reprogramming in safety mode, 2) full reset of a PM, which required the re-initialisation of the device and 3) programming change of the magnetic PM frequency to 30bpm (instead of 90 bpm). In all cases the Dmax delivered to the CIED was <1Gy. A neutron producing RT was used in the first two cases, whereas a non-neutron producing RT was used in the last case.
Conclusions
In accordance with the current literature, our results show that RT in patients with CIED is substantially safe. Malfunctions are uncommon and do not result in clinical events, but can develop even if the Dmax delivered to the CIED is <1 Gy. Device interrogation on a regular basis is advisable to promptly recognise CIED malfunctions.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz747.0288</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids></links><search><creatorcontrib>Imberti, J F</creatorcontrib><creatorcontrib>Placentino, F</creatorcontrib><creatorcontrib>Malavasi, V L</creatorcontrib><creatorcontrib>Demarco, G</creatorcontrib><creatorcontrib>Lohr, F</creatorcontrib><creatorcontrib>Boriani, G</creatorcontrib><title>P682Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices</title><title>European heart journal</title><description>Abstract
Background
The number of patients with cardiac implantable electronic devices (CIED) requiring a radiation therapy (RT) for cancer treatment is increasing over time. Nevertheless, the rate and predictors of CIED malfunctions are still controversial.
Purpose
The aim of our study is to estimate the prevalence and possible predictors of RT-related CIED malfunctions and to describe malfunction characteristics.
Methods
We retrospectively reviewed medical records of all pacemaker (PM)/implantable cardioverter defibrillator (ICD) patients who underwent RT at our centre between January 2004 and July 2018. We included data from the CIED interrogation performed before the RT course to the first interrogation after the end of the RT course. As a safety measure, during RT a magnet was applied to every ICD and, in all PM-dependent patients, the device was temporarily reprogrammed in V00. Device relocation from the RT field was performed in 2/150 (1.3%) RT courses.
Results
One hundred twenty-seven patients were included, who underwent 150 separate RT courses. Eighty one percent of patients had a PM, while 19% had an ICD. Of note 17.4% of patients were PM-dependent. Neutron producing RT was used in 37/139 (26.6%) patients, whereas marginal neutron producing and non-neutron producing RT was used in 9/139 (6.4%) and 93/139 (67%) patients respectively. The cumulative dose (Dmax) delivered to the CIED exceeded 5Gy only in 2/132 (1.5%) cases. Three device-related malfunctions were found (2%). None of them were life-threatening or lead to a clinical event. All dysfunctions were resolved by reprogramming the device and did not require CIED substitution or leads extraction. Details of dysfunctions included: 1) a partial reset of an ICD, leading to self-reprogramming in safety mode, 2) full reset of a PM, which required the re-initialisation of the device and 3) programming change of the magnetic PM frequency to 30bpm (instead of 90 bpm). In all cases the Dmax delivered to the CIED was <1Gy. A neutron producing RT was used in the first two cases, whereas a non-neutron producing RT was used in the last case.
Conclusions
In accordance with the current literature, our results show that RT in patients with CIED is substantially safe. Malfunctions are uncommon and do not result in clinical events, but can develop even if the Dmax delivered to the CIED is <1 Gy. Device interrogation on a regular basis is advisable to promptly recognise CIED malfunctions.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqN0N9KwzAUx_EgCs7pIwh5gW5JlqTppQz_gaDILrwr6ckJzejSkqbKfHo3Jl57deDA93fxIeSWswVn1WqJU2rRprxdYvtdynLBhDFnZMaVEEWlpTonM8YrVWhtPi7J1ThuGWNGcz0j8KaNeLcu9LnFZId9EaKbAB3d2c5PEXLoIw2Rgo2AiQ42B4x5pF8ht4dncsECDbuhszHbpkOKHUJOfQxAHX4GwPGaXHjbjXjze-dk83C_WT8VL6-Pz-u7lwJMaYpSNlyrxktTSgPCicZrjco3RksmpeaOe4ZqZUEKWZkKjORKOcFMpRTqcjUn6jQLqR_HhL4eUtjZtK85q49Q9R9UfYKqj1CHjp26fhr-mfwAvitx8A</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Imberti, J F</creator><creator>Placentino, F</creator><creator>Malavasi, V L</creator><creator>Demarco, G</creator><creator>Lohr, F</creator><creator>Boriani, G</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P682Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices</title><author>Imberti, J F ; Placentino, F ; Malavasi, V L ; Demarco, G ; Lohr, F ; Boriani, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c878-74b165bf48748c2d2bf66e5fb86404461d1f0e53ac424989c84155d208955e673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Imberti, J F</creatorcontrib><creatorcontrib>Placentino, F</creatorcontrib><creatorcontrib>Malavasi, V L</creatorcontrib><creatorcontrib>Demarco, G</creatorcontrib><creatorcontrib>Lohr, F</creatorcontrib><creatorcontrib>Boriani, G</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Imberti, J F</au><au>Placentino, F</au><au>Malavasi, V L</au><au>Demarco, G</au><au>Lohr, F</au><au>Boriani, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P682Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
The number of patients with cardiac implantable electronic devices (CIED) requiring a radiation therapy (RT) for cancer treatment is increasing over time. Nevertheless, the rate and predictors of CIED malfunctions are still controversial.
Purpose
The aim of our study is to estimate the prevalence and possible predictors of RT-related CIED malfunctions and to describe malfunction characteristics.
Methods
We retrospectively reviewed medical records of all pacemaker (PM)/implantable cardioverter defibrillator (ICD) patients who underwent RT at our centre between January 2004 and July 2018. We included data from the CIED interrogation performed before the RT course to the first interrogation after the end of the RT course. As a safety measure, during RT a magnet was applied to every ICD and, in all PM-dependent patients, the device was temporarily reprogrammed in V00. Device relocation from the RT field was performed in 2/150 (1.3%) RT courses.
Results
One hundred twenty-seven patients were included, who underwent 150 separate RT courses. Eighty one percent of patients had a PM, while 19% had an ICD. Of note 17.4% of patients were PM-dependent. Neutron producing RT was used in 37/139 (26.6%) patients, whereas marginal neutron producing and non-neutron producing RT was used in 9/139 (6.4%) and 93/139 (67%) patients respectively. The cumulative dose (Dmax) delivered to the CIED exceeded 5Gy only in 2/132 (1.5%) cases. Three device-related malfunctions were found (2%). None of them were life-threatening or lead to a clinical event. All dysfunctions were resolved by reprogramming the device and did not require CIED substitution or leads extraction. Details of dysfunctions included: 1) a partial reset of an ICD, leading to self-reprogramming in safety mode, 2) full reset of a PM, which required the re-initialisation of the device and 3) programming change of the magnetic PM frequency to 30bpm (instead of 90 bpm). In all cases the Dmax delivered to the CIED was <1Gy. A neutron producing RT was used in the first two cases, whereas a non-neutron producing RT was used in the last case.
Conclusions
In accordance with the current literature, our results show that RT in patients with CIED is substantially safe. Malfunctions are uncommon and do not result in clinical events, but can develop even if the Dmax delivered to the CIED is <1 Gy. Device interrogation on a regular basis is advisable to promptly recognise CIED malfunctions.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz747.0288</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-668X |
| ispartof | European heart journal, 2019-10, Vol.40 (Supplement_1) |
| issn | 0195-668X 1522-9645 |
| language | eng |
| recordid | cdi_crossref_primary_10_1093_eurheartj_ehz747_0288 |
| source | Electronic Journals Library; Oxford University Press Journals; Alma/SFX Local Collection |
| title | P682Radiotherapy-induced malfunction in cancer patients with cardiac implantable electronic devices |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T08%3A08%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=P682Radiotherapy-induced%20malfunction%20in%20cancer%20patients%20with%20cardiac%20implantable%20electronic%20devices&rft.jtitle=European%20heart%20journal&rft.au=Imberti,%20J%20F&rft.date=2019-10-01&rft.volume=40&rft.issue=Supplement_1&rft.issn=0195-668X&rft.eissn=1522-9645&rft_id=info:doi/10.1093/eurheartj/ehz747.0288&rft_dat=%3Coup_cross%3E10.1093/eurheartj/ehz747.0288%3C/oup_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/eurheartj/ehz747.0288&rfr_iscdi=true |