Effects of Ionizing Radiation on Cardiac Implantable Electronic Devices (CIEDs) in Patients with Esophageal Cancer Undergoing Radiotherapy: A Pilot Study

Author:

Uzun Davut D.123ORCID,Salatzki Janek23,Xynogalos Panagiotis23,Frey Norbert23,Debus Juergen456789,Lang Kristin456ORCID

Affiliation:

1. Department of Anesthesiology, Heidelberg University Hospital, 69120 Heidelberg, Germany

2. Heidelberg Center for Heart Rhythm Disorders (HCR), 69120 Heidelberg, Germany

3. Department of Cardiology, Heidelberg University Hospital, 69120 Heidelberg, Germany

4. Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany

5. Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany

6. National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany

7. Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, 69120 Heidelberg, Germany

8. Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany

9. German Cancer Consortium (DKTK), Partner Site Heidelberg, 69120 Heidelberg, Germany

Abstract

(1) Background: The prevalence of cancer patients relying on cardiac implantable electronic device (CIED) is steadily rising. The aim of this study was to evaluate RT-related malfunctions of CIEDs. (2) Methods: We retrospectively analyze sixteen patients with esophageal cancer who were treated with radiotherapy between 2012 and 2022 at the University Hospital Heidelberg. All patients underwent systemic evaluation including pre-therapeutic cardiological examinations of the CIED functionality and after every single irradiation. (3) Results: Sixteen patients, predominantly male (14) with a mean age of 77 (range: 56–85) years were enrolled. All patients received 28 fractions of radiotherapy with a cumulative total dose 58.8 Gy. The mean maximum dose at the CIEDs was 1.8 Gy. Following radiotherapy and during the one-year post-radiation follow-up period, there were no registered events associated with the treatment in this evaluation. (4) Conclusion: The study did not observe any severe CIED malfunctions following each radiation fraction or after completion of RT. Strict selection of photon energy and alignment with manufacturer-recommended dose limits appear to be important. Our study showed no major differences in the measured values of the pacing threshold, sensing threshold and lead impedance after RT.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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