Implantable Cardioverter Defibrillator Therapy in Adults With Congenital Heart Disease

Abstract

Adults with CHD and ICDs receive high rates of appropriate and effective shocks. Patients with secondary prevention indication, coronary artery disease, and symptomatic NSVT are at highest risk of receiving appropriate ICD shocks. ICD implantation is accompanied by considerable morbidity, including inappropriate shocks and procedure- related complications.

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

“…W sumie w ostatnich 2 dekadach leczenie za pomocą ICD u pacjentów z wrodzonymi wadami serca zmieniło charakter z prewencji wtórnej na pierwotną [490,491]. W retrospektywnych badaniach kohortowych wykazano, że oprócz VA również upośledzona czynność komory, lewej lub prawej, stała się niezmiennym czynnikiem ryzyka SCD u pacjentów z różnymi typami wrodzonych wad serca [493-495, 497, 498].…”

Long-Term Efficacy of Implantable Cardioverter Defibrillator in Repaired Tetralogy of Fallot ― Role of Anti-tachycardia Pacing ―

“…Koyak et al noted that ATP was effective in 5 of 26 repaired TOF patients. 3 In contrast, Witte et al found that ATP was highly effective in 4 of 4 repaired TOF patients. 5 In the present study, ATP was highly effective in 9 of 11 patients in whom ATP was attempted.…”

Late arrhythmia in patients with repaired tetralogy of Fallot: who is at risk?

“…Multi-central retrospective study by Koyak et al described non-sustained VTs as significant predictor for appropriate ICD shocks (HR 9.1, 95% CI 2.8-29.2, p < 0.001) [71]. Indication for secondary prevention was also associated with higher risk of appropriate shocks (HR 3.6, 95% CI 1.3-9.5, p = 0.009).…”

“…Importantly, patients with rTOF experience higher incidence of receiving inappropriate ICD shocks compared to patients with other CHDs (HR 3.6, 95% CI 1.0-12.4, p < 0.048) [71]. This often has negative impact on the mental state of these patients [69].…”