DEGRO/DGK guideline for radiotherapy in patients with cardiac implantable electronic devices

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• 作者：Dr. med. Benjamin Gauter-Fleckenstein MD…
• 关键词：Radiation therapy ; Cardiac pacemaker ; Implanted cardioverter/defibrillator ; Cardiac implantable electronic devices ; Ionizing radiation ; Strahlentherapie ; Herzschrittmacher ; Implantierter Kardioverter/Defibrillator ; Kardiale implantierte elektronische Ger?te ; Ionisierende Strahlung
• 刊名：Strahlentherapie und Onkologie
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：191
• 期：5
• 页码：393-404
• 全文大小：727 KB
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• 作者单位：Dr. med. Benjamin Gauter-Fleckenstein MD (1)
  Carsten W. Israel MD (2)
  Marc Dorenkamp MD (3)
  Jürgen Dunst MD (4)
  Mattias Roser MD (5)
  Rainer Schimpf MD (6)
  Volker Steil (1)
  J?rg Sch?fer MD (7)
  Ulrike H?ller MD (8)
  Frederik Wenz MD (1)
  
  1. Klinik für Strahlentherapie und Radioonkologie, Universit?tsmedizin Mannheim, Ruprecht-Karls-Universit?t Heidelberg, Theodor-Kutzer-Ufer 1-, 68167, Mannheim, Deutschland
  2. Klinik für Innere Medizin—Kardiologie, Diabetologie und Nephrologie, Ev. Krankenhaus Bielefeld, Bielefeld, Deutschland
  3. Medizinische Klinik mit Schwerpunkt Kardiologie, Charité—Universit?tsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
  4. Klinik für Strahlentherapie, Universit?tsklinik Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
  5. Medizinische Klinik für Kardiologie und Pulmologie, Charité—Universit?tsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland
  6. I. Medizinische Klinik—Kardiologie, Universit?tsmedizin Mannheim, Ruprecht-Karls-Universit?t Heidelberg, Heidelberg, Deutschland
  7. Strahlentherapie Speyer, Paul-Egell-Stra?e 31, 67346, Speyer, Deutschland
  8. Klinik für Radioonkologie und Strahlentherapie, Charité Universit?tsmedizin Berlin, Campus Charité Mitte, Berlin, Deutschland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Radiotherapy
  Oncology
  
• 出版者：Urban & Vogel
• ISSN：1439-099X

文摘

An increasing number of patients undergoing radiotherapy (RT) have cardiac implantable electronic devices [CIEDs, cardiac pacemakers (PMs) and implanted cardioverters/defibrillators (ICDs)]. Ionizing radiation can cause latent and permanent damage to CIEDs, which may result in loss of function in patients with asystole or ventricular fibrillation. Reviewing the current literature, the?interdisciplinary German guideline (DEGRO/DGK) was developed reflecting patient risk according to type of CIED, cardiac condition, and estimated radiation dose to the CIED. Planning for RT should consider the CIED specifications as well as patient-related characteristics (pacing-dependent, previous ventricular tachycardia/fibrillation). Antitachyarrhythmia therapy should be suspended in patients with ICDs, who should be under electrocardiographic monitoring with an external defibrillator on stand-by. The beam energy should be limited to 6 (to 10) MV CIEDs should never be located in the beam, and the cumulative scatter radiation dose should be limited to 2?Gy. Personnel must be able to respond adequately in the case of a cardiac emergency and initiate basic life support, while an emergency team capable of advanced life support should be available within 5?min. CIEDs need to be interrogated 1, 3, and 6?months after the last RT due to the risk of latent damage.