Effect of Diagnostic X-rays on Implantable Cardiac Pacemakers and Implantable Cardioverter Defibrillators, and Its Management

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  • Oda Nobuhiro
    Department of Radiological Technology, Faculty of Medical Science, Kyoto College of Medical Science
  • Nakajima Hiroshi
    Department of Arrhythmia and Heart Failure, Itabashi Chuo Medical Center
  • Abe Haruhiko
    Division of Cardiology and Kidney Disease, University Hospital, University of Occupational and Environmental Health
  • Koyama Syuji
    Department of Radiological Technology, School of Health Sciences, Nagoya University
  • Kakeda Shingo
    Department of Radiology, University of Occupational and Environmental Health, School of Medicine
  • Kourogi Yukunori
    Department of Radiology, University of Occupational and Environmental Health, School of Medicine

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Other Title
  • 植込み型心臓ペースメーカおよび植込み型除細動器に対する診断領域Ｘ線の影響とその対策
  • 臨床技術 植込み型心臓ペースメーカおよび植込み型除細動器に対する診断領域X線の影響とその対策
  • リンショウ ギジュツ ウエコミガタ シンゾウ ペースメーカ オヨビ ウエコミガタ ジョサイドウキ ニ タイスル シンダン リョウイキ Xセン ノ エイキョウ ト ソノ タイサク

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Abstract

The effects of diagnostic X-rays on implantable cardiac pacemakers and implantable cardioverter defibrillators (ICDs) were investigated. A total of 33 pacemakers from six manufacturers and nine ICDs from four manufacturers were irradiated using several X-ray units (plain X-ray diagnostic unit, under-table system fluoroscopy unit, over-table system fluoroscopy unit, biplane cardiac digital angiography unit, DSA unit and cone-beam CT unit). No systematic reset phenomena were observed in any pacemakers and ICDs under the X-ray irradiation. Nevertheless, over-sensing associated with the lack of a few pulses was observed in three of 33 pacemakers under radiation exposure. It has been proven that diagnostic X-rays might affect pacemaker function. Since the duration of the over-sensing under the radiation was very short and included transient episodes, this sensing failure, therefore, induced by radiation exposure would not affect the health of pacemaker recipients. ICDs were not affected by radiation exposure at a clinical dose. It is recommended that caution be exercised in direct irradiation to the pacemaker. Using a copper sheet of 2.0 mm thickness or more prevented over-sensing of pacemakers in the present study, especially when serial X-ray exposures were used with an over-table fluoroscopy system or cone-beam CT unit.

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