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. 2016 May;5(1):57-64.
doi: 10.15420/aer.2016.2.3.

Pacing and Defibrillators in Complex Congenital Heart Disease

Affiliations

Pacing and Defibrillators in Complex Congenital Heart Disease

Henry Chubb et al. Arrhythm Electrophysiol Rev. 2016 May.

Abstract

Device therapy in the complex congenital heart disease (CHD) population is a challenging field. There is a myriad of devices available, but none designed specifically for the CHD patient group, and a scarcity of prospective studies to guide best practice. Baseline cardiac anatomy, prior surgical and interventional procedures, existing tachyarrhythmias and the requirement for future intervention all play a substantial role in decision making. For both pacing systems and implantable cardioverter defibrillators, numerous factors impact on the merits of system location (endovascular versus non-endovascular), lead positioning, device selection and device programming. For those with Fontan circulation and following the atrial switch procedure there are also very specific considerations regarding access and potential complications. This review discusses the published guidelines, device indications and the best available evidence for guidance of device implantation in the complex CHD population.

Keywords: Congenital heart disease; arrhythmia; cardiac resynchronisation therapy; implantable cardioverter defibrillator; pacing; sudden cardiac death.

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Figures

Figure 1:
Figure 1:. Pacing Solutions in Patients with Hemi-Fontan Circulation, or Similar
Figure 2:
Figure 2:. Pacing in Patients with a Fontan Circulation
Figure 3:
Figure 3:. Pacing Following Atrial Switch Procedure

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