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An investigation into the effects of radiotherapy on implanted cardiac devices

Evans, Lauren Marie 2018. An investigation into the effects of radiotherapy on implanted cardiac devices. PhD Thesis, Cardiff University.
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Abstract

Introduction The number of cancer patients with CIEDs presenting for radiotherapy treatment is increasing. Technological advances in CIEDs have now made them more sensitive to ionising radiation and electromagnetic interference (EMI) than older bipolar semiconductor devices. External beam radiotherapy has the potential to cause CIED malfunction, this might be temporary but nevertheless, could result in catastrophic failure of the cardiac conduction system of the heart. It is not possible to predict the exact behaviour of a CIED when it is within, or close to, the radiotherapy treatment field. Published literature is inconsistent in its findings regarding the safe levels of ionising radiation dose delivered to CIEDs. The aims of this research are to determine the effects of ionising radiation and electromagnetic interferences upon CIEDs and leads. Method This research will adopt an experimental approach to data collection, under laboratory conditions, when CIEDs and CIEDs leads are exposed to ionising radiation and EMI. Results The scientific arm of this research focused on the effect of ionising radiation and EMI on CIEDs and CIED leads. The results showed that CIEDs exhibited a range of temporary and permanent malfunctions when exposed to cumulative ionising ! iv! radiation doses ranging from 0.5Gy to 3Gy. Results also, recommend that CIED leads should not be in the treatment field however, if this is unavoidable the radiation dose should be kept as low as possible. All CIEDs exhibited an effect when exposed to EMI and it is recommended that all patients with CIEDs receiving radiotherapy treatment should be monitored when in the radiotherapy treatment room. Conclusion This research identifies how CIEDs are adversely affected by ionising radiation and / or EMI, how these effects can be minimised, provide safe radiotherapy tolerance doses to CIEDs and issue recommendations for the publication of national guidelines for the safe management of patients with CIEDs undergoing radiotherapy treatment.

Item Type: Thesis (PhD)
Date Type: Submission
Status: Unpublished
Schools: Engineering
Uncontrolled Keywords: Cardiac Device (CIGD); Pacemaker; ICD; Radiotherapy; Ionising radiation; Electromagnetic interference (EMI).
Date of First Compliant Deposit: 5 October 2018
Last Modified: 05 Oct 2018 13:18
URI: http://orca-mwe.cf.ac.uk/id/eprint/115529

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