Yeung Cynthia, Hazim Bachar, Campbell Debra, Gooding Jim, Li Shirley Xl, Tam Ho Kit, Hopman Wilma M, Chacko Sanoj, Redfearn Damian P, Simpson Christopher, Abdollah Hoshiar, Baranchuk Adrian
Kingston Health Sciences Centre, Kingston, Ontario, K7L 2V7, Canada.
Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
J Interv Card Electrophysiol. 2019 Sep;55(3):333-341. doi: 10.1007/s10840-018-0506-0. Epub 2019 Jan 3.
As cardiovascular implantable electronic devices (CIEDs) are increasingly indicated in older patients, and the burden of cancer is rising with the aging population, the management of patients with CIEDs who require radiotherapy (RT) is a timely concern. The objective of the study was to evaluate the management of, and malfunctions in, patients with CIEDs undergoing RT.
A retrospective study of patients with CIEDs receiving RT at Kingston Health Sciences Center from March 2007-April 2018 was conducted. Data on demographics, RT, devices, and management were compared for the primary outcome of device malfunction.
Of the 189 patients with CIEDs receiving a total of 297 courses of RT, 4 patients (2.1%) experienced device malfunctions. Higher beam energy was associated with a malfunction (p < 0.05). Patients with malfunctions received a lower dose of radiation per fraction (267 ± 93 cGy vs. 477 ± 282 cGy; p < 0.05) and were significantly younger (71.4 ± 2.2 years vs. 77.8 ± 9.8 years; p < 0.01) compared to patients without malfunctions.
RT-induced device malfunctions are rare, but given the potential complications, a better understanding of the potential predictors of malfunction and the development of evidence-based guidelines will help optimize patient safety.
随着心血管植入式电子设备（CIED）在老年患者中的应用日益增多，且随着人口老龄化癌症负担不断上升，对需要放疗（RT）的CIED患者的管理成为一个紧迫问题。本研究的目的是评估接受RT的CIED患者的管理及故障情况。
对2007年3月至2018年4月在金斯顿健康科学中心接受RT的CIED患者进行回顾性研究。比较人口统计学、RT、设备及管理方面的数据，以设备故障作为主要结局。
在189例接受总共297个疗程RT的CIED患者中，4例（2.1%）出现设备故障。较高的束流能量与故障相关（p<0.05）。与无故障患者相比，出现故障的患者每次分割接受的辐射剂量较低（267±93 cGy对477±282 cGy；p<0.05），且年龄显著更小（71.4±2.2岁对77.8±9.8岁；p<0.01）。
RT引起的设备故障很少见，但鉴于潜在并发症，更好地了解故障的潜在预测因素并制定循证指南将有助于优化患者安全。
