TY - JOUR
T1 - Stereotactic arrhythmia radioablation
T2 - A multicenter pre-post intervention safety evaluation of the implantable cardioverter-defibrillator function
AU - van der Ree, Martijn H.
AU - Hoeksema, Wiert F.
AU - Luca, Adrian
AU - Visser, Jorrit
AU - Balgobind, Brian V.
AU - Zumbrink, Michiel
AU - Spier, Raymond
AU - Herrera-Siklody, Claudia
AU - Lee, Justin
AU - Bates, Matthew
AU - Daniel, Jim
AU - Peedell, Clive
AU - Boda-Heggemann, Judit
AU - Rudic, Boris
AU - Merten, Roland
AU - Dieleman, Edith M.
AU - Rinaldi, Cristopher A.
AU - Ahmad, Shahreen
AU - Whitaker, John
AU - Bhagirath, Pranav
AU - Hatton, Matthew Q.
AU - Riley, Stephen
AU - Grehn, Melanie
AU - Schiappacasse, Luis
AU - Blanck, Oliver
AU - Hohmann, Stephan
AU - Pruvot, Etienne
AU - Postema, Pieter G.
N1 - Funding Information: van der Ree has been supported by the Foundation “De Drie Lichten” in The Netherlands. Dutch Heart Foundation grant 03-003-2021-T061 to dr. Postema. The study participants partly received funding from the EU-Horizon-2020 STOPSTORM consortium project (Grant Agreement Number 945119) for STAR related projects, but this study was not directly funded by the EU-Horizon-2020 grant. Publisher Copyright: © 2023 The Author(s)
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Stereotactic arrhythmia radioablation (STAR) appears to be beneficial in selected patients with therapy-refractory ventricular tachycardia (VT). However, high-dose radiotherapy used for STAR-treatment may affect functioning of the patients’ implantable cardioverter defibrillator (ICD) by direct effects of radiation on ICD components or cardiac tissue. Currently, the effect of STAR on ICD functioning remains unknown. Methods: A retrospective pre-post multicenter study evaluating ICD functioning in the 12-month before and after STAR was performed. Patients with (non)ischemic cardiomyopathies with therapy-refractory VT and ICD who underwent STAR were included and the occurrence of ICD-related adverse events was collected. Evaluated ICD parameters included sensing, capture threshold and impedance. A linear mixed-effects model was used to investigate the association between STAR, radiotherapy dose and changes in lead parameters over time. Results: In total, 43 patients (88% male) were included in this study. All patients had an ICD with an additional right atrial lead in 34 (79%) and a ventricular lead in 17 (40%) patients. Median ICD-generator dose was 0.1 Gy and lead tip dose ranged from 0-32 Gy. In one patient (2%), a reset occurred during treatment, but otherwise, STAR and radiotherapy dose were not associated with clinically relevant alterations in ICD leads parameters. Conclusions: STAR treatment did not result in major ICD malfunction. Only one radiotherapy related adverse event occurred during the study follow-up without patient harm. No clinically relevant alterations in ICD functioning were observed after STAR in any of the leads. With the reported doses STAR appears to be safe.
AB - Background: Stereotactic arrhythmia radioablation (STAR) appears to be beneficial in selected patients with therapy-refractory ventricular tachycardia (VT). However, high-dose radiotherapy used for STAR-treatment may affect functioning of the patients’ implantable cardioverter defibrillator (ICD) by direct effects of radiation on ICD components or cardiac tissue. Currently, the effect of STAR on ICD functioning remains unknown. Methods: A retrospective pre-post multicenter study evaluating ICD functioning in the 12-month before and after STAR was performed. Patients with (non)ischemic cardiomyopathies with therapy-refractory VT and ICD who underwent STAR were included and the occurrence of ICD-related adverse events was collected. Evaluated ICD parameters included sensing, capture threshold and impedance. A linear mixed-effects model was used to investigate the association between STAR, radiotherapy dose and changes in lead parameters over time. Results: In total, 43 patients (88% male) were included in this study. All patients had an ICD with an additional right atrial lead in 34 (79%) and a ventricular lead in 17 (40%) patients. Median ICD-generator dose was 0.1 Gy and lead tip dose ranged from 0-32 Gy. In one patient (2%), a reset occurred during treatment, but otherwise, STAR and radiotherapy dose were not associated with clinically relevant alterations in ICD leads parameters. Conclusions: STAR treatment did not result in major ICD malfunction. Only one radiotherapy related adverse event occurred during the study follow-up without patient harm. No clinically relevant alterations in ICD functioning were observed after STAR in any of the leads. With the reported doses STAR appears to be safe.
KW - Cardiac radioablation
KW - Implantable cardioverter defibrillator (ICD)
KW - Safety
KW - stereotactic arrhythmia radiotherapy (STAR)
KW - ventricular tachycardia (VT)
UR - http://www.scopus.com/inward/record.url?scp=85172664591&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.radonc.2023.109910
DO - https://doi.org/10.1016/j.radonc.2023.109910
M3 - Article
C2 - 37709052
SN - 0167-8140
VL - 189
JO - Radiotherapy and oncology
JF - Radiotherapy and oncology
M1 - 109910
ER -