Proton beam therapy interference with implanted cardiac pacemakers.


PURPOSE To investigate the effect of proton beam therapy (PBT) on implanted cardiac pacemaker function. METHODS AND MATERIALS After a phantom study confirmed the safety of PBT in patients with cardiac pacemakers, we treated 8 patients with implanted pacemakers using PBT to a total tumor dose of 33-77 gray equivalents (GyE) in dose fractions of 2.2-6.6 GyE. The combined total number of PBT sessions was 127. Although all pulse generators remained outside the treatment field, 4 patients had pacing leads in the radiation field. All patients were monitored by means of electrocardiogram during treatment, and pacemakers were routinely examined before and after PBT. RESULTS The phantom study showed no effect of neutron scatter on pacemaker generators. In the study, changes in heart rate occurred three times (2.4%) in 2 patients. However, these patients remained completely asymptomatic throughout the PBT course. CONCLUSIONS PBT can result in pacemaker malfunctions that manifest as changes in pulse rate and pulse patterns. Therefore, patients with cardiac pacemakers should be monitored by means of electrocardiogram during PBT.

DOI: 10.1016/j.ijrobp.2008.01.062
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@article{Oshiro2008ProtonBT, title={Proton beam therapy interference with implanted cardiac pacemakers.}, author={Yoshiko Oshiro and Shinji Sugahara and Mio Noma and Masato Sato and Yuzuru Sakakibara and Takeji Sakae and Yasutaka Hayashi and Hidetsugu Nakayama and Koji Tsuboi and Nobuyoshi Fukumitsu and Ayae Kanemoto and Takayuki Hashimoto and Koichi Tokuuye}, journal={International journal of radiation oncology, biology, physics}, year={2008}, volume={72 3}, pages={723-7} }