Radiofrequency and microwave tumor ablation in patients with implanted cardiac devices: Is it safe?
| Autor: | Damian E. Dupuy, Elliot J. Wasser, Brendan D. Skonieczki, Catherine L. Wells |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Pacemaker Artificial medicine.medical_specialty Percutaneous medicine.medical_treatment Conscious Sedation Comorbidity Radiography Interventional Electrocardiography Informed consent Neoplasms medicine Humans Radiology Nuclear Medicine and imaging In patient Microwaves Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test Cardiac electrophysiology business.industry Retrospective cohort study General Medicine Institutional review board Ablation Defibrillators Implantable Surgery Treatment Outcome Catheter Ablation Female Patient Safety Radiology Tomography X-Ray Computed business |
| Zdroj: | European Journal of Radiology. 79:343-346 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2010.04.004 |
| Popis: | Purpose To identify malfunction of implanted cardiac devices during or after thermal ablation of tumors in lung, kidney, liver or bone, using radiofrequency (RF) or microwave (MW) energy. Materials and methods After providing written consent, 19 patients (15 men and 4 women; mean age 78 years) with pacemakers or pacemaker/defibrillators underwent 22 CT image-guided percutaneous RF or MW ablation of a variety of tumors. Before and after each procedure, cardiac devices were interrogated and reprogrammed by a trained cardiac electrophysiology fellow. Possible pacer malfunctions included abnormalities on electrocardiographic (EKG) monitoring and alterations in device settings. Our institutional review board approved this Health Insurance Portability and Accountability Act-compliant study. Informed consent for participation in this retrospective study was deemed unnecessary by our review board. Results During 20 of 22 sessions, no abnormalities were identified in continuous, EKG tracings or pacemaker functions. However, in two sessions significant changes, occurred in pacemaker parameters: inhibition of pacing during RF application in one, session and resetting of mode by RF energy in another session. These changes did not, result in hemodynamic instability of either patient. MW ablation was not associated with, any malfunction. In all 22 sessions, pacemakers were undamaged and successfully reset to original parameters. Conclusion RF or MW ablation of tumors in liver, kidney, bone and lung can be performed safely in patients with permanent intra-cardiac devices, but careful planning between radiology and cardiology is essential to avoid adverse outcomes. |
| Databáze: | OpenAIRE |
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