Implantable Cardioverter-defibrillators in Adult Congenital Heart Disease

Merrill H Stewart; Scott L Macicek; Daniel P Morin

doi:10.19102/icrm.2018.090601

Implantable Cardioverter-defibrillators in Adult Congenital Heart Disease

J Innov Card Rhythm Manag. 2018 Jun 15;9(6):3172-3181. doi: 10.19102/icrm.2018.090601. eCollection 2018 Jun.

Authors

Merrill H Stewart¹, Scott L Macicek², Daniel P Morin^{1

3}

Affiliations

¹ Department of Cardiology, Ochsner Medical Center, New Orleans, LA, USA.
² Department of Pediatric Cardiology, Ochsner Medical Center, New Orleans, LA, USA.
³ Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA.

Abstract

With improved surgical techniques and medical therapies, many patients who are born with complex congenital heart defects are now living well into adulthood. As these patients age, an increasingly common cause of mortality is sudden cardiac death (SCD) from ventricular tachyarrhythmias. The implantable cardioverter-defibrillator (ICD) is a therapy with the ability to prevent some of these deaths; however, there are many diagnostic and technical challenges that remain in the congenital heart disease (CHD) population. We performed a literature review, searching PubMed for articles that examined the role of ICDs in CHD. We herein present the evidence for when to place an ICD in CHD patients, stratified by subtype as relevant. Then, we discuss the technical challenges and complications that are unique to this patient population. We conclude that, despite active work in the area, more research is needed given the small event rates and clinical variability within CHD populations.

Keywords: Congenital heart defect; implantable cardioverter-defibrillator; sudden cardiac death; tetralogy of Fallot; transposition of the great arteries.

Publication types

Review