Outcome of implantable cardioverter defibrillator therapy for congenital heart disease.
BACKGROUND
The use of implantable cardioverter defibrillator (ICD) therapy for congenital heart disease (CHD) has been increasing, but few studies have reported on the efficacy of ICD therapy in Japanese CHD patients.


METHODS
Twelve CHD patients (median age, 35 years) with first ICD implantation were examined. Median follow-up duration was 2.9 years. Demographic information, implant electrical parameters, appropriate and inappropriate discharge data and complications were recorded for all implants from 2003 to 2010.


RESULTS
Implant indication was primary prevention in two patients and secondary prevention in 10. Overall four patients received one or more discharges; three patients (25%) with secondary prevention received nine appropriate discharges. Inappropriate discharge attributed to sinus tachycardia occurred in two patients (16.7%). Only one patient experienced the late complication of skin erosion at the generator implantation site.


CONCLUSIONS
Patients with CHD experienced significant rates of appropriate discharges and lower complications. But given that the indications of ICD implantation were mostly for secondary prevention, the ratio of appropriate shocks might be lower than in previous studies. In the primary prevention patients, the benefit of ICD was not clear because no appropriate discharges were seen during follow up. Although ICD implantation for CHD is beneficial for preventing sudden cardiac death, careful decision making and a large, long-term prospective study is required for the determination of the efficacy of ICD therapy in Japanese patients with CHD.
Department of Pediatric Cardiology, Sakakibara Heart Institute, Tokyo, Japan. tomchin2@r15.7-dj.com
Tomomi
T
Uyeda
Kanki
K
Inoue
Junichiro
J
Sato
Ayumi
A
Mizukami
Tadahiro
T
Yoshikawa
Naoki
N
Wada
Makoto
M
Ando
Yukihiro
Y
Takahashi
Jun
J
Umemura
In-Sam
IS
Park
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017147:Defibrillators, Implantable; D005260:Female; D006331:Heart Diseases / Q000151:congenital* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult