TY - JOUR
T1 - Management of patients with cardiac implantable electronic devices (CIED) undergoing radiotherapy
T2 - A consensus document from Associazione Italiana Aritmologia e Cardiostimolazione (AIAC), Associazione Italiana Radioterapia Oncologica (AIRO), Associazione Italiana Fisica Medica (AIFM)
AU - Zecchin, Massimo
AU - Severgnini, Mara
AU - Fiorentino, Alba
AU - Malavasi, Vincenzo Livio
AU - Menegotti, Loris
AU - Alongi, Filippo
AU - Catanzariti, Domenico
AU - Jereczek-Fossa, Barbara Alicja
AU - Stasi, Michele
AU - Russi, Elvio
AU - Boriani, Giuseppe
PY - 2018/3/15
Y1 - 2018/3/15
N2 - The management of patients with a cardiac implanted electronic device (CIED) receiving radiotherapy (RT) is challenging and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, radiation oncologists and physicists in order to stratify the risk of patients with CIED requiring RT and approaching RT sessions appropriately. When high radiation doses and beam energy higher than 6 MV are used, CIED malfunctions can occur during treatment. In our document, we reviewed the different types of RT and CIED behavior in the presence of ionizing radiations and electromagnetic interferences, from the cardiologist's, radiation oncologist's and medical physicist's point of view. We also reviewed in vitro and in vivo literature data and other national published guidelines on this issue so far. On the basis of literature data and consensus of experts, a detailed approach based on risk stratification and appropriate management of RT patients with CIEDs is suggested, with important implications for clinical practice.
AB - The management of patients with a cardiac implanted electronic device (CIED) receiving radiotherapy (RT) is challenging and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, radiation oncologists and physicists in order to stratify the risk of patients with CIED requiring RT and approaching RT sessions appropriately. When high radiation doses and beam energy higher than 6 MV are used, CIED malfunctions can occur during treatment. In our document, we reviewed the different types of RT and CIED behavior in the presence of ionizing radiations and electromagnetic interferences, from the cardiologist's, radiation oncologist's and medical physicist's point of view. We also reviewed in vitro and in vivo literature data and other national published guidelines on this issue so far. On the basis of literature data and consensus of experts, a detailed approach based on risk stratification and appropriate management of RT patients with CIEDs is suggested, with important implications for clinical practice.
KW - Cancer
KW - Cardiac resynchronization therapy
KW - Devices
KW - Implantable cardioverter defibrillator
KW - Pacemaker
KW - Radiotherapy
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U2 - 10.1016/j.ijcard.2017.12.061
DO - 10.1016/j.ijcard.2017.12.061
M3 - Article
AN - SCOPUS:85039994470
VL - 255
SP - 175
EP - 183
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -