Novel Pacemaker Relocation Method for Radiotherapy Against Overlapping Lung Cancer

We experienced a case of a patient with a history of pacemaker implantation who was found to have lung cancer just behind the pacemaker. She was an 80-year-old woman with a history of valve replacement, pacemaker implantation, and sarcoidosis. Computed tomography showed a ground-glass opacity of 1.5 cm in diameter in her left lung just posterior to the pacemaker. Pathology revealed that the lesion was an adenocarcinoma of the lung. The patient required radiation therapy. The pacemaker needed to be relocated to avoid radiation exposure. An 85-cm-long lead was inserted from the contralateral vein. This lead was connected through a long subcutaneous tunnel to a new generator implanted in the abdomen. The patient received 60 Gray stereotactic body radiotherapy for lung cancer and the lesion regressed. Relocation of the pacemaker to the abdominal wall using a long transvenous lead may be a promising measure to allow radiotherapy when the pacemaker overlaps with a malignant tumor.