Stereotactic arrhythmia radioablation: A multicenter pre-post intervention safety evaluation of the implantable cardioverter-defibrillator function.

Autor: van der Ree MH; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland., Hoeksema WF; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands., Luca A; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland., Visser J; Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, Amsterdam, The Netherlands., Balgobind BV; Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, Amsterdam, The Netherlands., Zumbrink M; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands., Spier R; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands., Herrera-Siklody C; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland., Lee J; Department of Cardiology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK., Bates M; Department of Cardiology, South Tees Hospitals NHS Foundation Trust, Middleborough, UK., Daniel J; Department of Radiation Oncology, South Tees Hospitals NHS Foundation Trust, Middlesborough, UK., Peedell C; Department of Radiation Oncology, South Tees Hospitals NHS Foundation Trust, Middlesborough, UK., Boda-Heggemann J; Department of Radiation Oncology, University Medical Center Mannheim University of Heidelberg, Mannheim, Germany., Rudic B; Department of Cardiology, University Medical Center Mannheim University of Heidelberg, Mannheim, Germany., Merten R; Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany., Dieleman EM; Amsterdam UMC location University of Amsterdam, Department of Radiation Oncology, Meibergdreef 9, Amsterdam, The Netherlands., Rinaldi CA; Department of Cardiology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Ahmad S; Department of Radiation Oncology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Whitaker J; Department of Cardiology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Bhagirath P; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Department of Cardiology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom., Hatton MQ; Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK., Riley S; Department of Clinical Oncology, Weston Park Hospital, Sheffield, UK., Grehn M; Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany., Schiappacasse L; Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland., Blanck O; Department of Radiation Oncology, University Medical Center Schleswig-Holstein, Kiel, Germany., Hohmann S; Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany., Pruvot E; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland., Postema PG; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: p.g.postema@amsterdamumc.nl.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2023 Dec; Vol. 189, pp. 109910. Date of Electronic Publication: 2023 Sep 12.
DOI: 10.1016/j.radonc.2023.109910
Abstrakt: Background: Stereotactic arrhythmia radioablation (STAR) appears to be beneficial in selected patients with therapy-refractory ventricular tachycardia (VT). However, high-dose radiotherapy used for STAR-treatment may affect functioning of the patients' implantable cardioverter defibrillator (ICD) by direct effects of radiation on ICD components or cardiac tissue. Currently, the effect of STAR on ICD functioning remains unknown.
Methods: A retrospective pre-post multicenter study evaluating ICD functioning in the 12-month before and after STAR was performed. Patients with (non)ischemic cardiomyopathies with therapy-refractory VT and ICD who underwent STAR were included and the occurrence of ICD-related adverse events was collected. Evaluated ICD parameters included sensing, capture threshold and impedance. A linear mixed-effects model was used to investigate the association between STAR, radiotherapy dose and changes in lead parameters over time.
Results: In total, 43 patients (88% male) were included in this study. All patients had an ICD with an additional right atrial lead in 34 (79%) and a ventricular lead in 17 (40%) patients. Median ICD-generator dose was 0.1 Gy and lead tip dose ranged from 0-32 Gy. In one patient (2%), a reset occurred during treatment, but otherwise, STAR and radiotherapy dose were not associated with clinically relevant alterations in ICD leads parameters.
Conclusions: STAR treatment did not result in major ICD malfunction. Only one radiotherapy related adverse event occurred during the study follow-up without patient harm. No clinically relevant alterations in ICD functioning were observed after STAR in any of the leads. With the reported doses STAR appears to be safe.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [SH reports speaker honoraria from Medtronic (outside the reported work). JBH reports consulting fees from EBAMEd SA (outside the reported work) and a research grant from Elekta (outside the reported work). JL declares a consultancy agreement with Varian Medical Systems (outside the reported work).].
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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