Long‐term follow‐up of adult patients with congenital heart disease and an implantable cardioverter defibrillator

Objective Sudden cardiac death is common in the adult congenital heart disease (ACHD) population. Knowledge and experience about the use of implantable cardioverter defibrillators (ICD) in ACHD patients is very limited. We aimed to characterize a cohort of patients with ACHD and ICDs. Design Thirty...

Full description

Saved in:
Bibliographic Details
Published in:Congenital heart disease 2019-07, Vol.14 (4), p.525-533
Main Authors: Coutinho Cruz, Madalena, Viveiros Monteiro, André, Portugal, Guilherme, Laranjo, Sérgio, Lousinha, Ana, Valente, Bruno, Osório, Paulo, Silva Cunha, Pedro, de Sousa, Lídia, Oliveira, José Alberto, Agapito, Ana, Martins Oliveira, Mário, Pinto, Fátima, Cruz Ferreira, Rui
Format: Article
Language:English
Subjects:
Adult
Cardiovascular disease
Congenital diseases
congenital heart defect
Death, Sudden, Cardiac - epidemiology
Death, Sudden, Cardiac - etiology
Death, Sudden, Cardiac - prevention & control
Defibrillators
Defibrillators, Implantable
Female
Fibrillation
Follow-Up Studies
Heart Defects, Congenital - complications
Heart Defects, Congenital - mortality
Heart Defects, Congenital - therapy
Heart diseases
Heart transplants
Humans
implantable cardioverter defibrillator
Implantation
Incidence
Male
Primary Prevention - methods
Prognosis
Remote monitoring
Retrospective Studies
supraventricular tachycardia
Survival Rate - trends
Tachycardia
Time Factors
Transplantation
Ventricular fibrillation
ventricular tachycardia
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective Sudden cardiac death is common in the adult congenital heart disease (ACHD) population. Knowledge and experience about the use of implantable cardioverter defibrillators (ICD) in ACHD patients is very limited. We aimed to characterize a cohort of patients with ACHD and ICDs. Design Thirty consecutive ACHD patients submitted to an ICD implantation in a single tertiary center were evaluated. Data on baseline clinical features, heart defect, indication for ICD, type of device, appropriate therapies, ICD‐related complication, and mortality during follow‐up were collected. Results Of the 30 patients, 56.7% received appropriate therapies due to ventricular tachycardia (VT) or ventricular fibrillation (VF). The rate of inappropriate therapies and device‐related complications was 33.3%. Secondary prevention and primary prevention patients with class I indications for ICD had more appropriate therapies than complication, but this relationship was reversed for patients with class II indications. Remote monitoring played an important role in diagnosing new atrial arrhythmias before scheduled visits in 46.2% of patients, leading to a change in medication. VT/VF episodes were associated with a composite of death, cardiac transplantation, and hospital admission (OR 13.0; 95% CI: 2.1‐81.5). Conclusion ICDs are not only useful in preventing SCD, but also have a major role in diagnosing atrial tachyarrhythmias ahead of scheduled visits. Although improvements in ICD technology might reduce complications and inappropriate therapies, adequate selection of candidates for primary prevention still remains difficult because of the lack of clear indications.
ISSN:1747-079X
1747-0803
DOI:10.1111/chd.12767