Radiation therapy (RT) can have significant effects on the function of cardiac pacemakers. Leadless pacemakers have been suggested as a promising alternative for patients with tumours of the upper chest/head due to the possibility of the pacemaker placed outside the field of interest. Nevertheless, effects of higher energy RT in patients with leadless pacemakers within the irradiation field is unknown. We report the case report of an 85year-old male implanted with a leadless pacemaker (Micra, Medtronic-Ibérica S.A., Spain), with an extensive mediastinal mass that required RT. As shown in the figure, the device was partially inside the radiation field, with beam range intersecting the device. Estimated maximum proton doses were 30 Gy in 15 sessions. Distribution of photon beam was 6 MV in anteroposterior and 15 MV in posteroanterior fields. Ultimately, patient accomplished all the scheduled sessions without any remarkable dysfunction (see Supplementary material online, Figure S1). In conclusion, in this first experience of RT in a patient with a leadless pacemaker implanted within the radiation field, continuous monitoring of device rule out remarkable damage to the pacemaker, endorsing its potential use in patients with RT requirements.
The full-length version of this report can be viewed at: http://www.escardio.org/Guidelines-&-Education/E-learning/Clinical-cases/Electrophysiology/EP-Case-Reports.
