16
Management of Patients with a CIED
Undergoing Radiation Therapy
Figure 3. Checklist for Performance of Radiation Treatment
CIED implantation date:
CIED implant indication:
Device manufacturer and model:
Pacing-dependent (intrinsic HR<40 bpm):
☐ Yes ☐ No
Complete weekly CIED evaluation recommended
1
:
☐ Yes ☐ No
System Features:
Pacemaker/CRT-P ☐ ICD/CRT-D ☐
Pacing mode: ___________________
Minimum pacing rate: ___________________
Maximum tracking rate: ___________________
Maximum sensor rate: ___________________
Measurements of the pacing system function and parameters
are stable
2
:
☐ Yes ☐ No
CIED Evaluation following completion of radiation therapy:
Measurements of the pacing system function and parameters
are stable
2
: ☐ Yes ☐ No
Comments:
RADIATION CLINIC CHECKLIST
Type of radiation course:
Neutron-producing
3
:
☐ Yes ☐ No
CIED location might interfere with adequate tumor
treatment
4
:
☐ Yes ☐ No
Maximum expected cumulative incident dose <5 Gy
5
:
☐ Yes ☐ No
1
It is recommended to perform a weekly CIED evaluation for patients undergoing neutron-
producing treatment and might be reasonable for pacing-dependent patients undergoing
non-neutron-producing treatment;
2
Device function – pacing output, pacing thresholds, sensing of R and P waves, lead
impedance, battery voltage and impedance;
3
Non-neutron-producing radiation is preferred [Neutron-producing : >10 mV photons,
protons, electrons ≥20 MeV];
4
CIED relocation is recommended if it will interfere with adequate tumor treatment;
5
CIED relocation is NOT recommended for devices receiving a max cumulative incident
dose of <5 Gy.
