Department of Cardiology, Canisius Wilhelmina Hospital, B16. PO Box 9015, 6500 GS, Nijmegen, The Netherlands.
Europace. 2013 Jan;15(1):60-5. doi: 10.1093/europace/eus197. Epub 2012 Jul 29.
To investigate the behaviour of the implantable cardioverter defibrillator (ICD) function during actual radiotherapy sessions.
Fifteen patients with an ICD underwent 17 radiation treatments for cancer [cumulative dose to the tumour was between 16 Gray (Gy) and 70 Gy; photon beams with maximum energies between 6 megaelectronvolt (MeV) and 18 MeV were employed]. During every session, the ICD was programmed to a monitoring mode to prevent inappropriate therapy delivery. Afterwards, the ICDs were interrogated to ensure proper function. Calculated radiation dose at the ICD site was <1 Gy in all patients. In 5 out of 17 radiation treatments (29%) the ICDs showed 6 malfunctions (35%). We noticed four disturbances in the memory data or device resets during radiation treatment and one case of inappropriate ventricular fibrillation detection due to external noise. In one case a late device data error was observed. All malfunctions occurred at 10 and 18 MeV beam energies.
Despite the fact that all recommended precautions were taken to minimize the damage to the ICDs during radiotherapy and the calculated dose to the ICDs was <1 Gy, in 29% of the treatments a malfunction occurred. We observed a possible correlation between the beam energy and the malfunctions. This correlation may be due to an interaction between neutrons produced in the head of the linear accelerator at beam energies ≥10 MeV, and boron-10 which is present in the integrated circuit.
研究植入式心脏复律除颤器（ICD）在实际放射治疗过程中的功能行为。
15 名植入 ICD 的患者接受了 17 次癌症放射治疗[肿瘤累积剂量为 16 戈瑞（Gy）至 70 Gy；使用最大能量在 6 兆电子伏特（MeV）至 18 MeV 之间的光子束]。在每次治疗中，ICD 被编程为监测模式以防止不适当的治疗传递。之后，对 ICD 进行了询问以确保其正常功能。所有患者 ICD 部位的计算辐射剂量均<1 Gy。在 17 次放射治疗中有 5 次（29%）显示出 6 种故障（35%）。我们注意到在放射治疗期间有四次干扰存储数据或设备重置，以及一次由于外部噪声导致的不适当心室颤动检测的情况。还有一例观察到迟发性设备数据错误。所有故障均发生在 10 和 18 MeV 束能量下。
尽管在放射治疗过程中采取了所有建议的预防措施来最大程度地减少对 ICD 的损害，并且计算出的 ICD 剂量<1 Gy，但在 29%的治疗中仍发生了故障。我们观察到束能量与故障之间可能存在相关性。这种相关性可能是由于在束能量≥10 MeV 的直线加速器头部产生的中子与存在于集成电路中的硼-10 之间的相互作用所致。
