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放疗前后心脏植入式电子设备导线参数的评估

Evaluation of cardiac implantable electronic device lead parameters before and after radiotherapy.

作者信息

Larsen Mia Bang, Jakobsen Annette Ross, Lundbye-Christensen Søren, Riahi Sam, Thøgersen Anna Margrethe, Zaremba Tomas

机构信息

Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

Department of Medical Physics, Oncology Department, Aalborg University Hospital, Aalborg, Denmark.

出版信息

Pacing Clin Electrophysiol. 2024 Sep;47(9):1176-1184. doi: 10.1111/pace.15048. Epub 2024 Jul 30.

Abstract

INTRODUCTION AND AIM

Radiotherapy in cancer patients with a pacemaker or an implantable cardioverter defibrillator might damage the device and possibly result in malfunction of the device. We aimed to examine device malfunction and change in lead parameters in this group.

METHODS

The medical records of pacemaker/implantable cardioverter defibrillator patients who underwent radiotherapy at Aalborg University Hospital between July 1, 2016, and June 30, 2021, were reviewed. Treatment was planned according to risk of device malfunction, assessed using local guidelines. Bootstrap linear regression was used to identify possible differences in lead parameters depending on beam energy and anatomical location.

RESULTS

One hundred nine patients with a pacemaker/implantable cardioverter defibrillator who received a total of 122 radiotherapy courses in the study period were identified. No device malfunctions or significant changes in lead parameters during radiotherapy were observed. Only the left ventricle lead threshold and impedance were found to be significantly different when compared by beam energy; however, these changes were relatively small and unlikely to be of clinical relevance.

CONCLUSION

No device malfunction or clinically relevant changes in lead parameters were identified in this study, suggesting that radiotherapy of pacemaker/implantable cardioverter defibrillator patients can be regarded as safe when following relevant safety precautions.

摘要

引言与目的

癌症患者接受放疗时若体内有起搏器或植入式心脏复律除颤器,可能会损坏该装置,并可能导致其出现故障。我们旨在研究该组患者的装置故障情况及导线参数的变化。

方法

回顾了2016年7月1日至2021年6月30日期间在奥尔堡大学医院接受放疗的起搏器/植入式心脏复律除颤器患者的病历。根据使用当地指南评估的装置故障风险来制定治疗计划。采用自助线性回归分析,以确定根据束流能量和解剖位置,导线参数是否存在可能的差异。

结果

研究期间共识别出109例植入起搏器/植入式心脏复律除颤器且接受了122个放疗疗程的患者。放疗期间未观察到装置故障或导线参数的显著变化。仅发现束流能量不同时,左心室导线阈值和阻抗存在显著差异;然而,这些变化相对较小,不太可能具有临床意义。

结论

本研究未发现装置故障或导线参数有临床相关变化,这表明在遵循相关安全预防措施的情况下,起搏器/植入式心脏复律除颤器患者的放疗可视为安全的。

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