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Erschienen in: Journal of Interventional Cardiac Electrophysiology 2/2014

01.03.2014

Radiation tolerance of contemporary implantable cardioverter-defibrillators

verfasst von: Michael Mollerus, Leslee Naslund, Margaret Lipinski, Anne Meyer, Bruce Libey, Ken Dornfeld

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2014

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Abstract

Background

Implantable cardioverter-defibrillators (ICDs) are complex instruments using integrated circuit technology. Previous studies suggested risk to the device when exposed to a radiation environment. Little data is available on contemporary ICD systems.

Objectives

The purpose of the present study was to assess the ability of contemporary ICD designs to resist the damaging effects of direct exposure to therapeutic doses of radiation.

Methods

Four contemporary ICDs and four legacy ICDs devices were exposed to escalating doses of photon irradiation (XRT) from a 6-MV linear accelerator. Escalating doses were administered over 8 days to a maximum cumulative dose of 131.11 Gy or catastrophic failure.

Results

Each legacy device had catastrophic failure following the 6th XRT session, characterized by failure to deliver shock therapy. All four contemporary devices remained fully functional following the 8th and final XRT session (P = 0.03). The cumulative, survived radiation dose was significantly different between the contemporary and legacy groups (131.11 vs. 41.11 Gy, P = 0.01). Changes seen in the legacy devices were sudden and not anticipated by trends in prior sessions.

Conclusion

The results of this study suggest that contemporary ICD designs may be more robust than earlier designs in a radiation environment.
Literatur
1.
Zurück zum Zitat Last, A. (1998). Radiotherapy in patients with cardiac pacemakers. British Journal of Radiology, 71(841), 4–10.PubMed Last, A. (1998). Radiotherapy in patients with cardiac pacemakers. British Journal of Radiology, 71(841), 4–10.PubMed
2.
Zurück zum Zitat Quertermous, T., Megahy, M. S., Das Gupta, D. S., & Griem, M. L. (1983). Pacemaker failure resulting from radiation damage. Radiology, 148(1), 257–258.PubMed Quertermous, T., Megahy, M. S., Das Gupta, D. S., & Griem, M. L. (1983). Pacemaker failure resulting from radiation damage. Radiology, 148(1), 257–258.PubMed
3.
Zurück zum Zitat Hurkmans, C. W., Scheepers, E., Springorum, B. G. F., & Uiterwaal, H. (2005). Influence of radiotherapy on the latest generation of implantable cardioverter-defibrillators. International Journal of Radiation Oncology, Biology, and Physics, 63(1), 282–289.CrossRef Hurkmans, C. W., Scheepers, E., Springorum, B. G. F., & Uiterwaal, H. (2005). Influence of radiotherapy on the latest generation of implantable cardioverter-defibrillators. International Journal of Radiation Oncology, Biology, and Physics, 63(1), 282–289.CrossRef
4.
Zurück zum Zitat Lewin, A. A., Serago, C. F., Schwade, J. G., Abitbol, A. A., & Margolis, S. C. (1984). Radiation induced failures of complementary metal oxide semiconductor containing pacemakers: a potentially lethal complication. International Journal of Radiation Oncology, Biology, and Physics, 10(10), 1967–1969.CrossRef Lewin, A. A., Serago, C. F., Schwade, J. G., Abitbol, A. A., & Margolis, S. C. (1984). Radiation induced failures of complementary metal oxide semiconductor containing pacemakers: a potentially lethal complication. International Journal of Radiation Oncology, Biology, and Physics, 10(10), 1967–1969.CrossRef
5.
Zurück zum Zitat Katzenberg, C. A., Marcus, F. I., Heusinkveld, R. S., & Mammana, R. B. (1982). Pacemaker failure due to radiation therapy. Pacing and Clinical Electrophysiology, 5(2), 156–159.PubMedCrossRef Katzenberg, C. A., Marcus, F. I., Heusinkveld, R. S., & Mammana, R. B. (1982). Pacemaker failure due to radiation therapy. Pacing and Clinical Electrophysiology, 5(2), 156–159.PubMedCrossRef
6.
Zurück zum Zitat Raitt, M. H., Stelzer, K. J., Laramore, G. E., Bardy, G. H., Dolack, G. L., Poole, J. E., et al. (1994). Runaway pacemaker during high-energy neutron radiation therapy. Chest, 106(3), 955–957.PubMedCrossRef Raitt, M. H., Stelzer, K. J., Laramore, G. E., Bardy, G. H., Dolack, G. L., Poole, J. E., et al. (1994). Runaway pacemaker during high-energy neutron radiation therapy. Chest, 106(3), 955–957.PubMedCrossRef
7.
Zurück zum Zitat Adamec, R., Haefliger, J. M., Killisch, J. P., Niederer, J., & Jaquet, P. (1982). Damaging effect of therapeutic radiation on programmable pacemakers. Pacing and Clinical Electrophysiology, 5(2), 146–150.PubMedCrossRef Adamec, R., Haefliger, J. M., Killisch, J. P., Niederer, J., & Jaquet, P. (1982). Damaging effect of therapeutic radiation on programmable pacemakers. Pacing and Clinical Electrophysiology, 5(2), 146–150.PubMedCrossRef
8.
Zurück zum Zitat Venselaar, J. L., Van Kerkoerle, H. L., & Vet, A. J. (1987). Radiation damage to pacemakers from radiotherapy. Pacing and Clinical Electrophysiology, 10(3 Pt 1), 538–542.PubMedCrossRef Venselaar, J. L., Van Kerkoerle, H. L., & Vet, A. J. (1987). Radiation damage to pacemakers from radiotherapy. Pacing and Clinical Electrophysiology, 10(3 Pt 1), 538–542.PubMedCrossRef
9.
Zurück zum Zitat Rodriguez, F., Filimonov, A., Henning, A., Coughlin, C., & Greenberg, M. (1991). Radiation-induced effects in multiprogrammable pacemakers and implantable defibrillators. Pacing and Clinical Electrophysiology, 14(12), 2143–2153.PubMedCrossRef Rodriguez, F., Filimonov, A., Henning, A., Coughlin, C., & Greenberg, M. (1991). Radiation-induced effects in multiprogrammable pacemakers and implantable defibrillators. Pacing and Clinical Electrophysiology, 14(12), 2143–2153.PubMedCrossRef
10.
Zurück zum Zitat Souliman, S. K., & Christie, J. (1994). Pacemaker failure induced by radiotherapy. Pacing and Clinical Electrophysiology, 17(3 Pt 1), 270–273.PubMedCrossRef Souliman, S. K., & Christie, J. (1994). Pacemaker failure induced by radiotherapy. Pacing and Clinical Electrophysiology, 17(3 Pt 1), 270–273.PubMedCrossRef
11.
Zurück zum Zitat Mouton, J., Haug, R., Bridier, A., Dodinot, B., & Eschwege, F. (2002). Influence of high-energy photon beam irradiation on pacemaker operation. Physics in Medicine and Biology, 47(16), 2879–2893.PubMedCrossRef Mouton, J., Haug, R., Bridier, A., Dodinot, B., & Eschwege, F. (2002). Influence of high-energy photon beam irradiation on pacemaker operation. Physics in Medicine and Biology, 47(16), 2879–2893.PubMedCrossRef
12.
Zurück zum Zitat Hurkmans, C. W., Scheepers, E., Springorum, B. G. F., & Uiterwaal, H. (2005). Influence of radiotherapy on the latest generation of pacemakers. Radiotherapy and Oncology, 76(1), 93–98.PubMedCrossRef Hurkmans, C. W., Scheepers, E., Springorum, B. G. F., & Uiterwaal, H. (2005). Influence of radiotherapy on the latest generation of pacemakers. Radiotherapy and Oncology, 76(1), 93–98.PubMedCrossRef
13.
Zurück zum Zitat Elders, J., Kunze-Busch, M., Jan Smeenk, R., & Smeets, J. L. R. M. (2013). High incidence of implantable cardioverter defibrillator malfunctions during radiation therapy: neutrons as a probable cause of soft errors. Europace, 15(1), 60–65.PubMedCrossRef Elders, J., Kunze-Busch, M., Jan Smeenk, R., & Smeets, J. L. R. M. (2013). High incidence of implantable cardioverter defibrillator malfunctions during radiation therapy: neutrons as a probable cause of soft errors. Europace, 15(1), 60–65.PubMedCrossRef
14.
Zurück zum Zitat Hekmat, K., Salemink, B., Lauterbach, G., Schwinger, R. H. G., Sudkamp, M., Weber, H. J., et al. (2004). Interference by cellular phones with permanent implanted pacemakers: an update. Europace, 6(4), 363–369.PubMedCrossRef Hekmat, K., Salemink, B., Lauterbach, G., Schwinger, R. H. G., Sudkamp, M., Weber, H. J., et al. (2004). Interference by cellular phones with permanent implanted pacemakers: an update. Europace, 6(4), 363–369.PubMedCrossRef
15.
Zurück zum Zitat Ferrick, A. M., Bernstein, N., Aizer, A., & Chinitz, L. (2008). Cosmic radiation induced software electrical resets in ICDs during air travel. Heart Rhythm, 5(8), 1201–1203.PubMedCrossRef Ferrick, A. M., Bernstein, N., Aizer, A., & Chinitz, L. (2008). Cosmic radiation induced software electrical resets in ICDs during air travel. Heart Rhythm, 5(8), 1201–1203.PubMedCrossRef
16.
Zurück zum Zitat Wadasadawala, T., Pandey, A., Agarwal, J. P., Jalali, R., Laskar, S. G., Chowdhary, S., et al. (2011). Radiation therapy with implanted cardiac pacemaker devices: a clinical and dosimetric analysis of patients and proposed precautions. Clinical Oncology (Royal College of Radiologists), 23(2), 79–85.CrossRef Wadasadawala, T., Pandey, A., Agarwal, J. P., Jalali, R., Laskar, S. G., Chowdhary, S., et al. (2011). Radiation therapy with implanted cardiac pacemaker devices: a clinical and dosimetric analysis of patients and proposed precautions. Clinical Oncology (Royal College of Radiologists), 23(2), 79–85.CrossRef
17.
Zurück zum Zitat Marbach, J. R., Sontag, M. R., Van Dyk, J., & Wolbarst, A. B. (1994). Management of radiation oncology patients with implanted cardiac pacemakers: report of AAPM Task Group No. 34. American Association of Physicists in Medicine. Medical Physics, e(1), 85–90. Marbach, J. R., Sontag, M. R., Van Dyk, J., & Wolbarst, A. B. (1994). Management of radiation oncology patients with implanted cardiac pacemakers: report of AAPM Task Group No. 34. American Association of Physicists in Medicine. Medical Physics, e(1), 85–90.
Metadaten
Titel
Radiation tolerance of contemporary implantable cardioverter-defibrillators
verfasst von
Michael Mollerus
Leslee Naslund
Margaret Lipinski
Anne Meyer
Bruce Libey
Ken Dornfeld
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2014
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-013-9861-z

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