TY - JOUR
T1 - Outcome of implantable cardioverter defibrillators in adults with congenital heart disease
T2 - A multi-centre study
AU - Yap, Sing Chien
AU - Roos-Hesselink, Jolien W.
AU - Hoendermis, Elke S.
AU - Budts, Werner
AU - Vliegen, Hubert W.
AU - Mulder, Barbara J.M.
AU - Van Dijk, Arie P.J.
AU - Schalij, Martin J.
AU - Drenthen, Willem
PY - 2007/8
Y1 - 2007/8
N2 - Aims: To investigate outcome and complications of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) and to identify predictors of (in-) appropriate shocks. Methods and results: Sixty-four CHD patients ≥ 18 years at first ICD implantation [63% tetralogy of Fallot (TOF) and age at implantation 37 ± 13 years] were identified using the Dutch adult CHD registry and a Belgian tertiary care centre database. Median follow-up duration was 3.7 years. Early complications included pocket haematoma (n = 3), lead failure (n = 2), and pneumothorax (n = 2). Late complications occurred in 11 (17%) patients, including lead failure (n = 6) and and electrical storm (n = 3). Overall, 30 device-related re-interventions were performed in 20 patients (31%), including four premature generator changes and seven lead replacements. Half of the patients received one or more shocks, and 46 shocks in 15 patients (23%) were classified as appropriate. One hundred and sixty shocks in 26 patients (41%) were classified as inappropriate. No predictors of (in-)appropriate shocks were identified, except TOF being associated with less appropriate shocks than patients with other CHD (HR 0.29, P = 0.02). Conclusion: The ICD provided effective therapy in a quarter of adults with CHD with low complication rates. The incidence of inappropriate shocks, however, appeared to be excessive and warrants further attention.
AB - Aims: To investigate outcome and complications of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) and to identify predictors of (in-) appropriate shocks. Methods and results: Sixty-four CHD patients ≥ 18 years at first ICD implantation [63% tetralogy of Fallot (TOF) and age at implantation 37 ± 13 years] were identified using the Dutch adult CHD registry and a Belgian tertiary care centre database. Median follow-up duration was 3.7 years. Early complications included pocket haematoma (n = 3), lead failure (n = 2), and pneumothorax (n = 2). Late complications occurred in 11 (17%) patients, including lead failure (n = 6) and and electrical storm (n = 3). Overall, 30 device-related re-interventions were performed in 20 patients (31%), including four premature generator changes and seven lead replacements. Half of the patients received one or more shocks, and 46 shocks in 15 patients (23%) were classified as appropriate. One hundred and sixty shocks in 26 patients (41%) were classified as inappropriate. No predictors of (in-)appropriate shocks were identified, except TOF being associated with less appropriate shocks than patients with other CHD (HR 0.29, P = 0.02). Conclusion: The ICD provided effective therapy in a quarter of adults with CHD with low complication rates. The incidence of inappropriate shocks, however, appeared to be excessive and warrants further attention.
UR - http://www.scopus.com/inward/record.url?scp=34547818717&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehl306
DO - 10.1093/eurheartj/ehl306
M3 - Article
C2 - 17030523
AN - SCOPUS:34547818717
SN - 0195-668X
VL - 28
SP - 1854
EP - 1861
JO - European Heart Journal
JF - European Heart Journal
IS - 15
ER -