Optimizing Radiation Dose and Utilizing Wearable Devices to Reduce Arrhythmia Risk in Patients Undergoing Thoracic Radiotherapy: A Prospective Cohort Study

Last updated: April 16, 2025
Sponsor: Yonsei University
Overall Status: Active - Not Recruiting

Phase

N/A

Condition

Atrial Fibrillation

Cardiovascular Disease

Arrhythmia

Treatment

N/A

Clinical Study ID

NCT06897189
4-2024-1631
  • Ages > 20
  • All Genders

Study Summary

This prospective observational cohort study aims to assess the risk of radiation-induced cardiotoxicity in patients undergoing thoracic radiotherapy by integrating real-time arrhythmia monitoring using wearable cardiac rehabilitation (wearable CR) devices and AI-based cardiac substructure segmentation. The study will analyze radiation dose exposure to key cardiac structures, including the sinoatrial node (SAN) and pulmonary veins (PV), to identify risk factors for atrial fibrillation (AF) and other arrhythmias. Patients will receive wearable CR monitoring at 3, 12, and 24 months post-radiotherapy, with cardiology follow-up and intervention based on standard clinical guidelines. The study will recruit 111 patients over three years, with a two-year follow-up after radiotherapy. The primary endpoint is the incidence of grade 3+ AF within 2 years, with secondary outcomes including any-grade arrhythmia rates, arrhythmia burden, and survival analysis. By establishing a prospective thoracic radiotherapy patient cohort, this study aims to identify dose-related risk factors, improve early detection and management of radiation-induced arrhythmias, and provide evidence-based strategies to enhance treatment safety and efficacy.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients with solid tumors requiring thoracic radiotherapy

  • Undergoing curative-intent radiotherapy

  • Expected survival > 4 months

  • Adults aged ≥ 20 years

  • ECOG performance status 0-2

  • Classified as moderate-to-high risk for radiation-induced cardiotoxicity per the 2022 ESC guidelines

  • Able to read, understand, and sign the informed consent form

Exclusion

Exclusion Criteria:

  • History of prior thoracic radiotherapy

  • Inability to provide informed consent or refusal to participate

  • Pre-existing arrhythmia diagnosed through medical history or pre-treatmentevaluation

  • Expected survival ≤ 4 months

  • Classified as low risk for radiation-induced cardiotoxicity per the 2022 ESCguidelines

  • Unsuitability for Wearable CR device use

Study Design

Total Participants: 111
Study Start date:
May 01, 2025
Estimated Completion Date:
February 16, 2030

Study Description

"This prospective observational cohort study aims to assess the risk of radiation-induced arrhythmias in patients undergoing thoracic radiotherapy for solid tumors, integrating real-time cardiac monitoring with wearable cardiac rhythm (Wearable CR) devices and AI-based cardiac substructure segmentation. The study will recruit 111 patients over three years, with a two-year follow-up post-radiotherapy. Patients will undergo Wearable CR monitoring at 3, 12, and 24 months, facilitating early detection and intervention based on standard cardiology guidelines. Radiation dose exposure to key cardiac structures, including the sinoatrial node (SAN) and pulmonary veins (PV), will be analyzed to evaluate correlations with atrial fibrillation (AF) and other arrhythmias. AI-driven segmentation will aid in optimizing dose distribution to minimize cardiotoxicity while maintaining treatment efficacy. The primary endpoint is the incidence of grade 3+ AF within 2 years, with secondary endpoints including any-grade arrhythmia rates, arrhythmia burden, and survival outcomes. All enrolled patients will receive standard radiotherapy protocols tailored to their respective cancer types, ensuring treatment consistency while assessing the impact of radiation on any kinds of cardiotoxicities.

Connect with a study center

  • Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System

    Seoul,
    Korea, Republic of

    Site Not Available

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