New generation implantable cardiac rhythm devices allow safe radiotherapy treatments: A large single centre study
Bibliographic record
Abstract
INTRODUCTION: Many patients requiring radiotherapy for malignancies have an already implanted cardiac rhythm device. Previous studies reported a variety of device dysfunctions related to high dose radiation. Aim of this study was to assess the impact of current optimal radiotherapy treatment guided by computed tomography on current generation implantable devices. METHODS: Consecutive patients with implanted pacemakers (PMK) and implantable cardioverter defibrillators (ICD) referred for radiotherapy treatment in any district were enrolled at our Centre and followed prospectively with device interrogation before and just after each radiotherapy cycle. A magnet was positioned on the device in patients with implanted defibrillators or pacemaker-dependency. RESULTS: Overall, 48 patients (74.8 years (9.3), 39 males (81.3)) with implantable devices underwent radiotherapy (29 pacemakers and 19 ICDs). Interval between device implant and start of radiation therapy was 2.9 (1.6) years. Radiotherapy was performed under computed tomography guidance, and a mean of 73.5 (45.0) Gy were administered with a mean of 24.8 (14.6) fractionated doses. About half of the patients underwent thoracic radiotherapy, and 9 were treated for a left thoracic malignancy ipsilateral to the implanted device. No device failures were observed at post-treatment device interrogation, nor changes in electrical parameters, inappropriate shocks, device reprogramming or memory reset. None of the patients experienced premature battery failure or other unexpected anomalous findings at the end of the radiation therapy cycle. CONCLUSION: Radiation therapy for malignancies is safe among patients with implanted current generation cardiac rhythm devices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".