Management of patients with cardiac implantable electronic devices (CIED) undergoing radiotherapy: A consensus document from Associazione Italiana Aritmologia e Cardiostimolazione (AIAC), Associazione Italiana Radioterapia Oncologica (AIRO), Associazione Italiana Fisica Medica (AIFM)

Massimo Zecchin, Mara Severgnini, Alba Fiorentino, Vincenzo Livio Malavasi, Loris Menegotti, Filippo Alongi, Domenico Catanzariti, Barbara Alicja Jereczek-Fossa, Michele Stasi, Elvio Russi, Giuseppe Boriani

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)175-183
Number of pages9
JournalInternational Journal of Cardiology
Volume255
DOIs
Publication statusPublished - Mar 15 2018

Keywords

  • Cancer
  • Cardiac resynchronization therapy
  • Devices
  • Implantable cardioverter defibrillator
  • Pacemaker
  • Radiotherapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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