Radiotherapy-induced Cardiac Implantable Electronic Device Dysfunction in Patients with Cancer

Abstract Radiotherapy can affect the electronic components of a cardiac implantable electronic device (CIED) resulting in malfunction and/or damage. We sought to assess the incidence, predictors and clinical impact of CIED dysfunction (CIED-D) following radiotherapy for cancer treatment. Clinical ch...

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Bibliographic Details
Published in:The American journal of cardiology 2017-01, Vol.119 (2), p.284-289
Main Authors: Bagur, Rodrigo, MD, PhD, Chamula, Mathilde, MD, Brouillard, Émilie, MD, Lavoie, Caroline, MD, Nombela-Franco, Luis, MD, PhD, Julien, Anne-Sophie, MSc, Archambault, Louis, PhD, Varfalvy, Nicolas, PhD, Gaudreault, Valérie, MD, PhD, Joncas, Sébastien X., MD, Israeli, Zeev, MD, Parviz, Yasir, MBBS, Mamas, Mamas A., DPhil, Lavi, Shahar, MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arrhythmias, Cardiac - complications
Arrhythmias, Cardiac - therapy
Cancer
Cancer therapies
Cardiovascular
Cardiovascular disease
Cohort Studies
Conduction
Confidence intervals
Damage assessment
Defibrillators
Defibrillators, Implantable
Disorders
Electronic components
Electronic devices
Equipment Failure
Female
Heart diseases
Humans
Impact damage
Incidence
Male
Men
Neoplasms - complications
Neoplasms - radiotherapy
Oncology
Pacemaker, Artificial
Pacemakers
Patients
Radiation
Radiation dosage
Radiation therapy
Radiotherapy - adverse effects
Regression analysis
Risk Factors
Side effects
Surgical implants
Transplants & implants
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Description
Summary:Abstract Radiotherapy can affect the electronic components of a cardiac implantable electronic device (CIED) resulting in malfunction and/or damage. We sought to assess the incidence, predictors and clinical impact of CIED dysfunction (CIED-D) following radiotherapy for cancer treatment. Clinical characteristics, cancer and different types of CIEDs as well as radiation-dose were evaluated. The investigation identified 230 patients; mean age 78±8 years and 70% were male. A total of 199 (86%) patients had pacemakers (59% dual-chamber), 21 (9%) cardioverter-defibrillators and 10 (4%) resynchronizators/defibrillators. The left pectoral (n=192, 83%) was the most common CIED location. Sixteen (7%) patients experienced 18 events of CIED-D after radiotherapy. Reset to back-up pacing mode was the most common encountered dysfunction, and only 1 (6%) patient of those with CIED-D experienced symptoms of atrio-ventricular dys-synchrony. Those who had CIED-D had a shorter device-age at the time of radiotherapy compared to those who did not (2.5±1.5 vs. 3.8±3.4 years, P =0.005). The total dose prescribed to the tumor (66±30 vs. 42±23 Gy) was significantly higher among those who had CIED-D (P
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.09.036