Do you restrict the dose rate during treatment delivery to a pacemaker in addition to limiting the Dmax?

3 Answers

Mednet Member

Radiation Oncology · Loma Linda University

Delivering a high dose rate implies that the pacemaker would be exposed to the machine's direct output. High-dose-rate exposure to a pacemaker could lead to an instantaneous malfunction and, even if temporary, should be avoided. Please err on the safe side.

Mednet Member

Radiation Oncology · University of Illinois, College of Medicine

AAPM has very detailed guidelines for the Management of radiotherapy patients with implanted cardiac pacemakers and defibrillators: A Report of the AAPM TG-203. Miften et al., PMID 31571229

Also from Practical Rad Onc: Fagerstrom and Marotta, PMID 37578411.

Mednet Member

Radiation Oncology · University of Texas at Tyler

Avoid heroics; call the patient's electrophysiologist and request that he move the pacemaker/CIED to the patient's right side, far away from the target. It is a same-day surgery and requires light anesthesia. If the patient's device is intracardiac and immovable, then defer radiation therapy. No dev...