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Pacing in congenital heart disease - A four-decade experience in a single tertiary centre.

Abstract：

BACKGROUND:The increased risk of brady- and tachy-arrhythmias in the congenital heart disease (CHD) population means that cardiac rhythm management devices are often required at an early age and expose patients to device-related complications. The present study drew upon four decades of experience at a tertiary adult congenital heart disease ACHD center and aimed to investigate the indication for cardiac implantable electronic devices (CIEDs) and predictors of late device-related complication requiring re-intervention. METHODS:A retrospective review of pacing records of ACHD patients over forty years was carried out. The primary outcome measure was device related complication requiring re-intervention. RESULTS:Between 1970 and 2009, 238 structural CHD patients who received CIEDs with follow-up data were identified (structural group). As a comparator group, 98 patients with congenital conduction disease or long QT syndrome with a structurally normal heart (electrical group) were included in the study. During a mean follow-up of 9.6±8.5years, 72 (21%) patients (44 structural group, 28 electrical group) required ≥1 re-intervention due to device related complications. Multivariate analysis showed that age at the time of device implant was an independent predictor of late device-related complications (HR 0.77, 95% CI 0.60-0.98, p=0.04). Sub-analysis of the structural group showed that ACHD complexity (Bethesda guideline) was the only predictor late device-related complication in the structural group (HR 2.96, 95% CI: 1.67-5.26, p<0.01). CONCLUSION:Increasing age at device implant was inversely associated with late device-related complications. ACHD patients with complex anatomy are at increased risk of device-related complications at mid and long-term follow-up.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Midha D,Chen Z,Jones DG,Williams HJ,Lascelles K,Jarman J,Clague J,Till J,Dimopoulos K,Babu-Narayan SV,Markides V,Gatzoulis MA,Wong T

doi

10.1016/j.ijcard.2017.02.151

subject

Has Abstract

pub_date

2017-08-15 00:00:00

pages

177-181

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(16)32208-2

journal_volume

241

pub_type

杂志文章

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