Implantable defibrillators: from the adult cardiac to the grown up congenital heart disease patient

Pathophysiology of Congenital Heart Disease in the Adult

“…47 Antitachycardia pacing may benefit some patients who are established to be at greatest risk for life-threatening arrhythmia. 48 Most often, adult tetralogy of Fallot patients present with new-onset or increasing exercise intolerance and must be evaluated to rule out both potentially important surgical residua and ventricular myocardial issues. RV dilatation and dysfunction are common in this group and are most often related to long-standing pulmonary regurgitation in patients who have had surgical manipulation of the valve.…”

Coarctation of the descending aorta, patent ductus arteriosus, deficiency of right superior vena cava, and persistent left superior vena cava in a five-month infant demonstrated by multislice computed tomography

“…Congenital heart diseases have several morphological abnormalities [1][2][3][4][5][6][7][8][9][10][11]and it is very important to recognize the spatial relationship of abnormal structures accurately before deciding on a surgical strategy [12][13][14][15][16][17]. Conventional angiogram has been considered a gold standard to evaluate the abnormal structures but the images are two-dimensional and sometimes it is difficult to recognize the complex spatial relationship of abnormalities three-dimensionally.…”

Tachyarrhythmias in congenital heart disease

“…This change has the potential to influence the risk of arrhythmias and the treatment approach through ablation. The characterization of the arrhythmogenic substrate and anatomical isthmuses, achieved via 3D reconstruction of late gadolinium-enhanced MRI, EPS and EAM in sinus rhythm, could emerge as a valuable tool for risk stratification concerning VT and SD in individuals with repaired CHD ( 23 , 55 , 94 , 95 ). Further studies are necessary to elucidate the role of empirical ablation during pulmonary valve replacement in patients with repaired Tetralogy of Fallot ( 96 , 97 ).…”