What radiation dose is a risk for damaging function or active leads from a pacemaker?
If the pacemaker receives no dose, what dose are the leads allowed to receive and still function? Should interrogation(s) be done weekly?
Does dose per fraction (vs. total dose) make a difference to active tips (or main box)?
Note: The wires between the box and the end of the active leads (tips) are not likely to be affected by radiation.
The AAPM 2019 summary may be of help.
Answer from: Radiation Oncologist at Community Practice
Lots of attention has been placed on the dose to the device itself (and to a lesser extent the leads of implanted devices such as pacemakers). The type and purpose of the device are very important and plays a role in what is permissible dose to the unit. For example, the risk to a pacemaker on which...
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Answer from: Radiation Oncologist at Academic Institution
This is a complex issue sometimes asked on our weekly OLA/ABR website. According to the updated 2019 AAPM TG-203 report published in Medical Physics by Miften et al., (PMID 34604807), and the JACC review by Fradley et al., (PMID 31571229), care for patients with CIEDs requires careful...
Answer from: at Academic Institution
Zaremba et al., PMID 25601489. Beam energy >15MV is associated with higher risk of CIED complications. Guidelines are found here. Fradley et al., PMID 34604807. >5 Gy cumulative dose is considered high risk. Complete CIED interrogation at baseline and after RT is complete, at 1 month...
Comments
Radiation Oncologist at SJRO PC
We try to keep the dose to 2 cGy or less. The devi...
We try to keep the dose to 2 cGy or less. The devi...
Radiation Oncologist at Mon Health
Did you mean to say 2 Gray?
Did you mean to say 2 Gray?